Washington Nurse - Winter 2012

The Washington Nurse Campaign for Patient Safety 2012 Legislative Session Documenting Unsafe Conditions

A Publication of the Washington State Nurses Association

Volume 41, No 4 Winter 2012

The fight to give patients safer care.

It starts with safe staffing.

Volume 41, No 4 Winter 2012

2 1 0 2 , 3 1 Y r a U r B e B e a pa rt O F It! F

n U r S e Le G I S LatI v e d

aY

InvIted SpeakerS: Gubernatorial candidates Jay Inslee and Rob McKenna Morning education sessions at Great Wolf Lodge

Lunch and afternoon activities at the Capitol in Olympia

Free shuttle between Olympia and Great Wolf Lodge provided before and after education sessions.

www.wsna.org/legday

Contents

Safe care starts with safe staffing.

WSNA Launches Campaign for Patient Safety 22

– Winter 2012 – U P FRONT

N U RSI NG P RACTICE

L E G I S L ATI V E A F FA I R S

MEMBER NEWS

5 You Were Represented

14 The Future of Nursing

22 Cover Story: Campaign

33 The New Members List

5 Calendar

for Patient Safety

15 Are You Protected

from Liability?

6 In Focus

27 State Budget Crisis

Continues

LABOR NEWS

NEWS

35 In Memoriam:

Hilda Boerhave Roberts 36 March of Dimes Nurse

30 Budget Priorities for

of the Year Awards

2012 Legislative Session

8 News Briefs

20 St. Joseph in Bellinham

9 ANA News 12 District News

31 Issue Brief: Hazardous

Fight for Respect and a Voice 21 How-to: Protect Yourself

KCNA & IENA

E D U C ATI O N

Drugs in the Workplace 32 Legislative & Health

by Documenting Unsafe Conditions

Policy Platform for 2012

38 Continuing Education

Calendar 41 News & Upcoming

WSNA Education Events

21 Recently Settled

Contracts

– Spotlight Events – WSNA Nurse Legislative Day

WSNA Hall of Fame

ANA House of Delegates

February 13, 2012

March 27, 2012

June 13, 2012 – June 16, 2012

Olympia, WA

Seattle, WA

Washington, D.C.

The Washington Nurse | Winter 2012 | 3

WSNA Board of Directors & Staff

President Julia A. Weinberg, RN – Bow

Chair, Cabinet on Economic & General Welfare Kathy Ormsby, RN – Yakima

WASHINGTON STATE NURSES ASSOCIATION

Vice President Susan E Jacobson, RN, CCRN – Yakima

Chair, Professional Nursing & Health Care Council Jeaux Rinehart, RN – Seattle

206.575.7979 • 206.575.1908 fax • wsna@wsna.org

Secretary / Treasurer Verlee Sutherlin, MEd, MSN, RN – Nine Mile Falls

Chair, Legislative & Health Policy Council Ed Dolle, RN – Port Orchard

Directors-at-Large Pat Lombard – Bellingham Jennifer Graves, RN, MS, ARNP – Seattle Judi M. Lyons, RN – Ellensburg Patricia Di Egido Tobis – Seattle Ann Whitley, RN – Yakima

Receptionist / Mail Clerk Irene Mueller

Special Projects Manager Darlene Delgado, RN

Assistant Executive Director, Nursing Practice, Education & Research Sally Watkins, PhD, MS, RN Education Specialist Hilke Faber, MN, RN, FAAN

Bookkeeper Mary Reed

Occupational & Environmental Health Specialist Karen R. Bowman, MN, RN, COHN-S

Assistant Executive Director, Government Affairs and Operations Anne Tan Piazza

Assistant Executive Director, Labor Relations Christine Himmelsbach, MN, RN

Senior Governmental Affairs Advisor Sofia Aragon, JD, BSN, RN

Senior Labor Consultant Barbara E. Frye, BSN, RN

Political Action Coordinator Richard Burton

Assistant Director, Labor Relations Margaret Conley, RN, ARNP

Communications Specialist Lillie Cridland

General / Corporate Counsel Timothy Sears

Web & Communications Specialist Ben Tilden

General Counsel Laura Anderson Michael Sanderson

Contract Lobbyist Tamara Warnke Operations / Systems Administrator Duncan Taylor Membership Coordinator Mary Peterson Membership Processors Patrick McGraw Louise Hohbach Membership Processor / Clerical Support Kelly King Membership Processor / Administrative Assistant, Labor Relations Shastie Steinshouer Administrative Assistant, Programs & Operations Hue Tran Communications Processor Kathryn MacLeod

4 | The Washington Nurse | Winter 2012

www.wsna.org The Washington Nurse (ISSN# 0734-5666) newsmagazine is published quarterly by the Washington State Nurses Association. It is distributed as a benefit of membership to all WSNA members. A member rate of $10 per year is included in WSNA membership dues.

Institutional subscription rate is $30 per year (Canada/ Mexico: US $36 per year; Foreign: US $49 per year).

Executive Director Judith A. Huntington, MN, RN

Executive Administrative Assistant to the Executive Director Barbara Bergeron

575 Andover Park West, Suite 101, Seattle, WA 98188

Paralegal Maria Pettit Nurse Representatives Debra Bessmer, BSN, RN Sara Frey, JD, BSN, RN Barbara Friesen, BSN, RN Carmen Garrison BSN, RN Kathi Landon, RN Judy Marken, BSN, RN Pat McClure, RN Jaclyn Perkins, BSN, RN Michele Rose, BSN, RN Hanna Welander, BSN, RN Terri Williams, RN Ed Zercher, BSN, RN Nurse Organizers Jan Bussert, BSN, RN Tara Goode, BA, BSN, RN Mara Kieval, BSN, RN

The information in this newsmagazine is for the benefit of WSNA members. WSNA is a multi-purpose, multifaceted organization. The Washington Nurse provides a forum for members of all specialties and interests to express their opinions. Opinions expressed are the responsibilities of the authors and do not necessarily reflect the opinions of the officers or membership of WSNA, unless so stated. Copyright 2012, WSNA. No part of this publication may be reproduced without permission.

ADVERTISING Information on advertising rates may be obtained on the WSNA website or by contacting the WSNA Business Agent at 206.575.7979. Advertising deadlines are: March 1, June 1, September 1, and December 1. Advertising will be accepted on a first come, first served basis for preferred positions, pending space availability. WSNA reserves the right to reject advertising. Paid advertisements in The Washington Nurse do not necessarily reflect the endorsement of the WSNA Members, Staff or Organization.

CONTRI B UTOR G U I DE LI N ES Article ideas and unsolicited manuscripts are welcome from WSNA members (300 word maximum). Please submit a typed copy and digital copy (Microsoft Word, or plain text) and include identified relevant photos, a biographical statement, your name, address and credentials. It is not the policy of WSNA to pay for articles or artwork.

ARTICLE SUBMISSION DEADLINES Spring .......................................................................... February 15 Summer................................................................................. May 15 Fall .................................................................................... August 15 Winter...................................................................... November 15

DESIGNED, EDITED & PRINTED IN THE USA

You Were Represented ■ The WSNA staff and elected and appointed leaders represent your interests in a wide variety of meetings, coalitions, conferences and work groups throughout the year, anticipating and responding to the issues the membership has identified as priorities. In addition to many meetings with legislators, regulators, policy makers, other health care and nursing organizations and unions, the following represents a partial listing of the many places and meetings where you were represented during the last three months.

• Alliance of Nurses for Health Environments (ANHE) Policy/Advocacy Committee • American Nurses Association (ANA) Board of Directors meeting • ANA Dues Evaluation Task Force • ANA Nursing Practice Network conference calls • ANA Congress on Nursing Practice and Economics • ANA Constituent Member State annual lobbyist meeting • ANA Constituent Assembly • ARNP Coalition Meeting • Council of Nurse Educators for Washington State (CNEWS) • Collaborative on a Healthy Environment (CHE-WA) • Department of Health (DOH) Healthcare Associated Infections Advisory Committee • DOH Sunrise Review Study on Medical Assistants • Department of Labor and Industries rulemaking on hazardous drug exposure • Federal Basic Health Option legislative advisory committee • Health Care Access Coalition (to maintain access to medications) • Health Care Without Harm • Health Coalition for Children and Youth • Healthy Washington Coalition to Healthy Washington Steering Committee • Inland Empire Nurses Association annual legislative reception • March of Dimes ‘Nurse of the Year’ celebration for Western Washington including Selection Committee • NFN National Executive Board meetings & National Advisory Board meetings • Northwest Organization of Nurse Executives (NWONE) Nursing Education & Practice Commission • Nursing Care Quality Assurance Commission Meetings (NCQAC) • NCQAC Continuing Competency Subcommittee • NCQAC Nursing Practice Advisory Group for Consistent Standards of Practice Subcommittee • NCQAC stakeholder meeting regarding medication assistants in Long Term Care • NSO Advisory Board

• Nursing Students of Washington State (NSWS) Board meetings • Northwest Parish Nurse conference • Office of the Chief Medical Officer, CMS, Region X, HHS • Public Health Emergency Preparedness and Response (PHEPR) Program Joint Advisory Committee • Public Health Funding Roundtable • Puget Sound Health Alliance and Consumer Engagement Team meetings • Racial Equity Team • Rebuilding Our Economic Future Coalition • RWJF “IOM Report on Future of Nursing” WA-RAC planning • Ruckelshaus Safe Staffing Steering Committee Meetings • Toxic Free Legacy Coalition • United Labor Lobby • Washington Center for Nursing (WCN) Board Meetings • WCN Faculty Compensation workgroup for Master Plan for Education • Washington Regional Action Coalition (WNAC) Steering Committee • WNAC Statewide conference on IOM Future of Nursing recommendations • Washington Chapter of Physicians for Social Responsibility • Washington Community Action Network (WA-CAN) Rally in Olympia • Washington Health Foundation Board Meeting • Washington Patient Safety Steering Committee and Medication Safety initiative • Washington State Board of Community and Technical Colleges • Washington State Labor Council Legislative Labor Caucus • Washington State Labor Council Political Committee • Washington State Joint Conference on Health • Washington State Public Health Association Board meeting • Washington Toxics Coalition • Wednesday Night Study Group Health Professions Lobby yearly retreat • Western Governors University-Washington

Calendar February 4 Professional Nursing and Health Care Council 11 WSNA Culture of Safety Workshop — Jackson Hall, Tacoma, WA 12 Legislative and Health Policy Council and WSNA-PAC — Olympia, WA 13 WSNA Legislative Day — Great Wolf Lodge, Grand Mound, WA 17 Finance / Executive Committees 20 Presidents’ Day Observed office closed 23-24 NFN Board Meetings — Portland, OR

March 2 CEARP Committee 5 Washington State Nurses Foundation Board of Trustees 10 Nursing Students of Washington State Convention — Great Wolf Lodge, Grand Mound, WA 14 WSNA Culture of Safety Workshop — Vancouver, WA 27 Board of Directors 27 2012 WSNA Hall of Fame Event — Salty’s on Alki, Seattle, WA 28 WSNA Board of Directors

April 17 WSNA Continued Competency Workshop — Yakima, WA 25 WSNA Culture of Safety Workshop — Skagit Valley Casino, Bow, WA 26 CEARP Committee 26-27 CNEWS — Spokane, WA

May 3-6 NFN Labor Academy and NFN Board Meeting — Chicago, IL 18-23 International Congress of Nursing (ICN) — Melbourne, Australia 21 WSNA Board of Directors

28

Memorial Day Observed office closed

—

More…

June 13–16, 2012 ANA House of Delegates September 22–25, 2012 WSNA Leadership Conference

The Washington Nurse | Winter 2012 | 5

In Focus

By Julia Weinberg, RN WSNA President

We begin the new year much like we ended the last year, fighting against dangerous budget cuts. Our work and the work of our Legislators during Special Session did not solve the two billion dollar budget crisis facing us in 2012. We must continue to push back against an all-cuts budget that would slash essential health programs. Keeping our health infrastructure intact—such as our public health systems, the basic health plan, disability lifeline and other safety net programs— must be our top budgetary priority. It’s time to raise revenue in Washington to ensure that we are protecting our most vulnerable in this state.

We know that this will be an ongoing struggle; one that will require all of our best efforts, our resolve and our unity.

We also know, as nurses, that the time has come to take a stand on staffing.

We are also embarking on a new challenge in 2012. With the launch of the Campaign for Patient Safety, WSNA is bringing together all aspects of our organization to fight for safe nurse staffing. We know that this will be an ongoing struggle; one that will require all of our best efforts, our resolve and our unity. We also know, as nurses, that the time has come to take a stand on staffing.

Across the state, our staffing committees have had mixed results. Some have achieved partial success under the law while others are nonexistent or dysfunctional, to say the least. Of course, inadequate staffing leads to missed breaks and stopgap measures like mandatory call. These shortcut solutions come with

6 | The Washington Nurse | Winter 2012

a price – increased fatigue and burn out.

What we need is a real solution and that means getting our staffing levels up to where they need to be so that each of us can provide the highest level of care.

We have tried a staffing law that relies on voluntary cooperation and the belief that management and staff nurses should be able to work together towards common goals. Many people from WSNA, SEIU, UFCW, Washington State Hospital Association (WSHA) and Northwest Organization of Nurse Executives (NWONE) have spent countless hours in mediated sessions through the Ruckelshaus process to come to agreements on issues of staffing and breaks. These good faith efforts have fallen short. What we need now is new legislation, specifically, a law that has teeth and that will guarantee we have safe staffing standards in Washington.

I am energized and hopeful. Looking forward, I ask myself what will keep me charging forward. There is much going on right now that can derail us or leave us depressed, hopeless and apathetic. Yet on the other hand, when I look around, read the papers, or watch the news, there are people everywhere speaking out, marching, chanting and organizing. People are standing up and fighting against the status quo.

The list includes the movement of the 99%; Occupy Wall Street; the ‘We are One’ labor union movement; the recall election of the governor in Wisconsin; the amazing win recently in Ohio on the referendum vote of the people to overturn SB5; and it goes on and on.

Nurses are standing up for themselves and for their patients. I recently attended a rally in Bellingham to support our St. Joseph Hospital nurses who felt they were not being heard and given the respect

they deserved. Management brought in consultants who told them to restructure and switch every nurse to eight hour shifts. Nurses had no meaningful input.

The nurses knew that focusing on shift lengths instead of staffing, missed breaks, and overtime, would not solve anything.

Through incredible unity and effort, those nurses stopped unilateral implementation and brought management back into meaningful conversations At facility after facility, nurses are holding firm during very difficult contract negotiations to keep both patient safety and nurse safety as top priorities. In particular, when it comes to floating to different units, nurses are insisting on appropriate training and on a better process for identifying when it makes sense to float and how often. Nurses are also standing up and speaking out when layoffs and restructures happen to let the public know when patient care is at risk.

Do you see a trend here? I do. Do you see the power in the voices and the actions of empowered nurses here? I do.

I have a nurse colleague who compared nursing to a sleeping giant. She wondered what the limits to our power would be if we awakened and spoke together, not just in Washington but all across this country.

Not only is this vision becoming a reality, but we are leading the way. With the Campaign for Patient Safety, WSNA is at the forefront of nursing issues in this country.

It’s an exciting time and an opportunity for each one of us to have an impact in our workplaces, in this state, and beyond.

We need to drive home the message that registered nurses are the beating heart of health care and not a cost driver. In fact, we are a revenue generator. Since 2010, hospitals and others have been paid for performance and standards will only get

Creating healthier lives.

It’s the Washington Way.

stricter and better defined in July of 2012.

Having appropriate staffing models with enough registered nurses to provide safe patient care does benefit the bottom line.

We are the ones who ensure that hospitals meet their performance goals. We are the ones responsible for the clinical care outcomes every day and every shift. When you decrease or eliminate ‘never events’ from happening in the first place, dollars are saved.

To change a culture takes time and commitment from all involved. Change will not occur overnight or because we do the education. Change will occur when employers and employees determine change is needed and required by all. Then, and only then, will the culture change for the better. WSNA has already been working to educate our members and hospital administrators about creating a Culture of Safety in hospitals. Reducing errors takes effort from every person at every level of a hospital. Eliminating errors means focusing on improving systems and procedures, not punitive measures for individuals.

This education goes hand in hand with the legislative work we are doing now. It is time for nurses to stand up and stand together. As the providers at the bedside, we are the ones who know our patients and know this health care system. Our Legislators need to hear from us and the public needs to hear from us. Let’s use our powerful voice for powerful change.

Nurses, united, will never be divided!

WSNA—leading the way!

■

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The Washington Nurse | Winter 2012 | 7

News Briefs

AMERICAN ACADEMY OF NURSING INDUCTS 5 WASHINGTON STATE NURSES AS FAANS The American Academy of Nurses (AAN) inducted five Washington State nurses into their 2011 class of 142 new Fellows at their 38th annual meeting and conference in Washington DC on October 15th. The new AAN Fellows from Washington State are: • • • • •

NURSES KEEP TOP SPOT FOR HONESTY AND ETHICS IN POLL RANKING PROFESSIONS For the 12th year, nurses were voted the most trusted profession in America in Gallup’s annual survey that ranks professions based on their honesty and ethical standards. Eighty-four percent of Americans rated nurses’ honesty and ethical standards as “very high” or “high.”

Since the profession’s first appearance in the poll in 1999, nurses have received the highest ranking each year except in 2001, when firefighters ranked first.

Nurses consistently demonstrate honesty and high ethical standards in their everyday dealings with patients and their families. However, a recent high-profile legal case underscored the commitment nurses demonstrate to patient safety and quality. In 2009, two Texas nurses reported a physician at their hospital for unsafe practices. The nurses withstood intimidation and criminal charges, but held firm to their principles. Justice ultimately prevailed when the legal battles concluded in November. Four individuals involved with bringing charges against the nurses were either convicted or pled guilty to misuse of official information and retaliation.

8 | The Washington Nurse | Winter 2012

Betty Bekemeir, PhD, MPH, MSN, RN, University of Washington Cynthia Dougherty, PhD, ARNP, RN, University of Washington Brenda Zierler, PhD, RVT, RN, University of Washington Neva Crogan-Pomilla, PhD, GCNS-BS, GNP-BC, RN, Washington State University Lori Loan, PhD, RNC-NIC, Madigan Healthcare Systems

The Academy serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Every day across America, the Academy and its members create and execute knowledge-driven and policy-related initiatives to drive reform of America's health care system. The Academy was founded in 1973 under the aegis of the American Nurses Association, but today is an independent affiliate of the ANA. The Academy's 1,800 members­—known as Fellows—are nursing's most accomplished leaders in education, management, practice and research. They have been recognized for their extraordinary nursing careers and are among the nation's most highly-educated citizens; more than 80 percent hold doctoral degrees, and the rest have completed masters programs. Sixty-four percent of the Fellowship work in academic settings, 30 percent work in service and practice settings, and about 3 percent work in state and federal government agencies. Fellows are encouraged to participate in one of the Academy's Expert Panels that correlates with their area of expertise. Currently, 22 Expert Panels serve as the working groups of the Academy. ❱❱ Visit www.aannet.org/ for more information.

NATIONAL PRESCRIPTION DRUG TAKE BACK DAY SCHEDULED FOR APRIL 28, 2012 Save the date! April 28, 2012 is the next National Prescription Drug Take Back Day. This will be a great time to dispose of no longer needed prescription drugs by taking them to a Drug Enforcement Agency (DEA)-sponsored event site. By preventing the diversion of potentially dangerous drugs to those they were not prescribed for, the DEA is able to help safeguard public health.

Americans that participated in the DEA’s third National Prescription Drug Take-

Back Day on October 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take-back sites that were available in all 50 states and U.S. territories. When the results of the three prior Take Back Days are combined, the DEA, and its state, local, and tribal law-enforcement and community partners have removed 995,185 pounds (498.5 tons) of medication from circulation in the past 13 months.

❱❱ For more information please visit: www.deadiversion.usdoj.gov/drug_disposal/takeback

News ANA

NURSES' HEALTH STUDY SEEKS NEW SET OF PARTICIPANTS The landmark Nurses' Health Study is recruiting a new cohort of 100,000 female nurses and nursing students ages 20 to 46 from across the U.S. and Canada.

Described as the world's largest and longest-running set of research on women's health, the Nurses' Health Study has included more than 230,000 participants since the 1970s. By completing confidential lifestyle surveys for more than three decades, the participating nurses have enhanced medical knowledge about nutrition, exercise, cancer and heart disease.

For example, bolstered by evidence from the study, according to a news release, many restaurants ban artificial trans fats. In the study, these fats were shown to contribute to heart disease.

The Nurses' Health Study III will explore important issues in women's health— including those related to the environment, work life, fertility and the effects of lifestyle—on a younger and more diverse group of women.

NHS3 is conducted entirely online, with participants completing brief confidential surveys every six months.

Approximately 20,000 nurses and nursing students have enrolled to date through sponsoring nursing associations, direct mail, social networks, the media and word-of-mouth through current participants. Recruitment will continue until the goal of 100,000 participants has been reached. ❱❱ Eligible nurses can learn more on the study's website: www.nhs3.org/

ANA AND NCSBN UNITE TO PROVIDE GUIDELINES ON SOCIAL MEDIA AND NETWORKING FOR NURSES ANA and the National Council of State “Social media can be a powerful tool, one Boards of Nursing (NCSBN) have mutu- with the potential to enhance or underally endorsed each organization’s guide- mine not only the individual nurse’s lines for upholding professional boundar- career, but also the nursing profession,” ies in a social networking environment. said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “ANA hopes these The use of social media and other elecprinciples provide a framework for all tronic communication is expanding exponurses to maintain professional stannentially; the latest statistics indicate dards in a world where communication that there are 150 million U.S. Facebook is ever changing.” accounts, and Twitter processes more than 250 million tweets worldwide on a daily basis. Social networking can be a Social media can foster professional positive tool that fosters professional connections, enriches a nurse’s knowledge connections, enrich your knowledge base, and promotes timely communica- base, and enable timelier tion with patients and family members. communications, but it is paramount ANA and NCSBN caution nurses that that patient privacy and confidentiality they need to be aware of the potential con- be maintained at all times. sequences of disclosing patient-related information via social media and mindful of employer policies, relevant state and ANA’s e-publication, “ANA’s Principles federal laws, and professional standards for Social Networking and the Nurse,” proregarding patient privacy and confiden- vides guidance to registered nurses on tiality. using social networking media in a way that protects patients’ privacy, confi“Nurses must recognize that it is paradentiality and inherent dignity. This mount that they maintain patient privacy publication is available as a downloadand confidentiality at all times, regardless able, searchable PDF, which is compatof the mechanism that is being used to ible with most e-readers. It is free to transmit the message, be it social networkANA members on the Members-Only ing or a simple conversation. As licensed Section of www.nursingworld.org; nonprofessionals they are legally bound to members may order the publication at maintain the appropriate boundaries and www.nursesbooks.org. ANA also protreat patients with dignity and respect,” vides additional resources at its Social comments NCSBN Board of Directors Networking Principles Toolkit page at President Myra A. Broadway, JD, MS, RN, http://bit.ly/uzw8yo. executive director, Maine State Board of Nursing.

The Washington Nurse | Winter 2012 | 9

News ANA

ANA PROMOTES HIGHER QUALITY ELECTRONIC DOCUMENTATION

MARILYN TAVENNER NOMINATED TO HEAD CENTERS FOR MEDICARE AND MEDICAID SERVICES

ANA, as part of a coalition to promote nurse involvement in the development of quality measures for electronic health record (EHR) documentation, hosted a conference at its Silver Spring, MD, headquarters on September 13-14, “Tipping Point 2 – A Blueprint for Action: Demonstrating Care Coordination in All Settings with HIT Enabled Pressure Ulcer Quality Measures.”

ANA commends the White House for its decision to nominate Marilyn Tavenner, MHA, BSN, RN, to head the Centers for Medicare and Medicaid Services (CMS).

Tavenner, a former ICU nurse, has served as Chief Executive Officer of the Hospital Corporation of America (HCA) and was Virginia’s secretary of Health and Human Resources under then-Governor Tim Kaine. Most recently, Tavenner worked as CMS’s principle deputy administrator.

improving care for the patient. ANA looks forward to working with Tavenner to implement the provisions of the Affordable Care Act so that Americans can benefit from a system that is more responsive to their need for accessible and high quality care.”

If approved through Senate confirmation, Tavenner will replace Don Berwick, MD, who was appointed by President Obama in July 2010. ANA commends Berwick for his work at CMS, most significantly as an innovator and catalyst for quality improvement.

The Institute of Medicine’s (IOM ) report, The Future of Nursing: Leading Change, “Marilyn Tavenner will make an excelAdvancing Health, released October 2010, lent CMS administrator,” remarked stressed that nurses “can and should play ANA President Karen Daley, PhD, MPH, a fundamental role” in the transformation RN, FAAN. “As a nurse, her focus is on of the health care system. ANA has taken a leadership role in utilizing technology as ADVERTISEM ENT a necessary tool to innovate the delivery of care and looks to the Tipping Point meetings to solidify nursing’s role in developing and contributing to the transformation of the national quality health IT landscape.

ANA supports enhanced reporting of health care outcomes with a focus on quality. Specifically, it supports the adoption of pressure ulcers measures as quality measures that demand care coordination and encompass all age spectrums and settings of care. ANA has been a long-time advocate for the inclusion of quality indicators in health IT systems and has been working to advance nursing’s quality agenda through strategic investment in measure development for future stages of meaningful use. ❱❱ To learn more about ANA’s quality work please visit www.ncnq.org.

10 | The Washington Nurse | Winter 2012

News ANA

SURVEY: WORK ENVIRONMENT SAFER, MORE CAN BE DONE Patient lifting equipment and needles with safety devices are more prevalent today than 10 years ago in health care facilities, contributing to a safer overall work environment for registered nurses, yet more can be done to reduce hazards and promote a workplace culture that prioritizes nurses’ health and safety, according to a new ANA survey.

What’s clear from the 2011 Health and Safety Survey is that nursing still is tough on the body. And recent U.S. Bureau of Labor Statistics figures support the survey’s findings about the relatively high risk of harm, ranking nursing fifth of all occupations in work days missed due to occupational injuries and illnesses. ANA’s survey shows 80 percent of nurses with neck, back or shoulder pain caused by the job frequently work despite pain. And 13 percent say they had been injured three or more times on the job within a year, compared to 7 percent in 2001.

The survey, which drew responses from 4,614 RNs, reveals the same top three work environment concerns as in a similar 2001 ANA survey: the acute or chronic effects of stress and overwork (74 percent of respondents); disabling musculoskeletal injury (62 percent); and risk of contracting an infectious disease (43 percent).

Creating a healthier, safer workplace is crucial to building and maintaining an adequate nursing workforce, which has suffered from recurring shortages.

Several recent studies have shown that dissatisfaction with the nursing work environment—including stressful working conditions leading to burnout, heavy physical demands and difficult work schedules—influences nurses’ decisions to leave direct-care nursing. ANA’s survey supports these findings, indicating that nearly 6 in 10 nurses agree that health and safety concerns influence their decision to continue practicing in the nursing field.

Nearly two-thirds of nurses say they have ready access to patient lifting and transfer devices, compared to less than half in 2001.

But even though the devices are more available, less than one-third of nurses say they use them frequently, suggesting that selection and placement of patient lift and transfer devices need to be evaluated.

Increased education and changes in workplace culture may also help increase safety.

Health care employers have been more accountable in providing safe needle devices, with 96 percent of RN respondents saying they are available, compared to 82 percent in 2001. But the survey shows that RNs may benefit from a better understanding of their rights under the Needlestick Safety and Prevention Act (2000), which requires that direct-care professionals participate in identifying and selecting safer needle devices: 62 percent either don’t know if nurses are involved in the selection process, or say they aren’t involved.

Though concerns about on-the-job physical assault have increased since 2001 (25 percent to 34 percent), the percentage of RNs who say they were assaulted decreased from 17 percent to 11 percent.

The majority of nurses still say they have been verbally abused or threatened on the job within a year, though the occurrence decreased since 2001 (57 percent to 52 percent).

Emotional and physical exhaustion can drive nurses from direct care. Overall, the survey shows a trend toward healthier work schedules. The percentage of nurses working more than 40 hours per week decreased from 64 percent to 55 percent, and RNs who work some mandatory or unplanned overtime each month decreased from 68 percent to 53 percent.

W S N A S TA F F O P E N I N G

Nursing Practice Specialist This position involves strategic planning, implementation and evaluation of activities at a statewide level that advance nursing practice and ensures nursing’s presence in healthcare community at large. Core competencies require leadership, consultation, mentoring, coaching, persuasion, and provision of services to diverse groups around areas of nursing practice, education, and research.

Duties and responsibilities include but are not limited to: • Forecasting, identifying, and analyzing significant emerging issues, trends and developments impacting practice of nursing, delivery of health care, and the association.

• Collaborating and making connections with key constituents, and representing WSNA for advanced practice issues regularly attending ARNP specialty group meetings.

• Collaborating with governmental affairs staff regarding potential legislative / regulatory issues; providing testimony as requested for key practice issues.

• Maintaining WSNA’s on-line CNE program. Exploring and implementing new learning formats such as webcasts, podcasts, posting of “live” CNE events for web-based access, etc.

• Assisting with identification of grant / research opportunities and establishment of statewide nursing research agenda.

Qualifications: RN license in WA State; credentialed as ARNP preferred. Masters in Nursing and at least five years experience; PhD preferred. Experience with regulatory boards, volunteer organizations and / or committees preferred.

Knowledge of Washington State Nurse Practice Act preferred.

The Nursing Practice Specialist reports to the Assistant Executive Director of Practice, Education, and Research.

Contact Sally Watkins, PhD, RN at swatkins@wsna.org for more information.

The Washington Nurse | Winter 2012 | 11

Districts King County Nurses Association

King County Nurses Association

Inland Empire Nurses Association

DISTRICT 2

DISTRICT 4

District Meeting: Mentoring in Nursing How a Mentor Relationship Can Change Your (Professional) Life Wednesday, February 15,2012 5:30–7:30pm Good Shepherd Center (Wallingford A light supper will be served.

Increasingly, nursing students and new nurses are seeking mentor relationships to provide support as they “learn the ropes” in the profession. At the same time, many veteran nurses are anxious to share their experience in a meaningful way for the next generation.

So whether you’re a student, a new RN, or an experienced nurse looking to share your expertise, you will want to join us to hear this program. A general discussion will identify ways to find a mentor, or be a mentor, inside or outside of the work or school environment.

This program is free. To register, visit www.kcnurses.org.

Annual Meeting & Spring Banquet Thursday, May 10, 2012 Shilshole Bay Beach Club The scholarship deadline and KCNA Annual Meeting & Spring Banquet will be here before you know it! Visit www.kcnurses.org for more details.

• Do you know a nursing student who needs a scholarship? Or perhaps you are a student who needs a scholarship. Next spring, KCNA will award 12 scholarships of $2,500 each, including awards to undergraduates, graduate students and RNB students.

KCNA Scholarship applications are on-line; completed applications are due by March 1.

• Heads up! The 2012 KCNA Annual Meeting & Spring Banquet is scheduled for Thursday, May 10. This is a festive event that celebrates the nursing profession—including the annual KCNA Auction to support scholarships and the presentation of annual Shining Star nursing awards. Held at the Shilshole Bay Beach Club, the evening includes a gourmet meal, wonderful northwest views and a chance to connect with nurses from a variety of specialties and practice settings. Early-bird registration (save $5!) is available at www.kcnurses.org until March 15.

The IENA Board welcomed two new faces, Camille Sturdivant-Daly as Director-atLarge and Rachel Inman as General Duty Representative. Thanks to both Camille and Rachel for volunteering to serve the nurses in our community!

The positions below are currently open: •

Board Secretary

•

Director-at-Large

•

Independent Practice Rep (CRNA, ARNP, etc)

•

Nursing Management Rep (Administration)

Your professional experience is invaluable in promoting the nursing profession and advocating for health and safety in our community. If you or anyone you know is interested in serving on the IENA BOD, please contact Administrative Secretary JoAnn Kaiser at iena@aimcomm.net.

There are immeasurable benefits to serving on our BOD! During our Annual Legislative Reception on 4 October 2011, three of our BOD members met with WSNA staffers and Senator Lisa Brown (Dist 3) and discussed critical issues such as the lack of mental health beds and resources in the Inland Empire and the absolute need for increasing nursing instructor salaries. The reception was again cosponsored by the Washington Association of Nurse Anesthetists and the Nurse Practitioners Group of Spokane.

What a team we make! Since this is an annual event, mark your calendar now for October 2012.

2012 Events LUC Dinner on Us Monday, January 9, 2012 This important event was sponsored by IENA and was an opportunity for the IENA Board of Directors to strengthen our connection with Local Unit Chairs

12 | The Washington Nurse | Winter 2012

Districts Inland Empire Nurses Association

and Co-Chairs, and to discuss how we can support nurses in our community.

Nursing concerns were discussed and attendees offered their suggestions for future educational topics.

WSNA Nurse Legislative Day Monday, February 13, 2012 Great Wolf Lodge, Grand Mound and State Capitol, Olympia We invite you to participate in Nurse Legislative Day, a great opportunity to learn how to advocate for your profession and all patients in Washington State. You will also have the opportunity to voice your concerns regarding nursing issues to state legislators. Morning education sessions will be held at Great Wolf Lodge in Grand Mound. Visit with legislators and attend hearings in Olympia for the afternoon.

(Shuttle transportation provided).

IENA will again sponsor a charter bus from Spokane to Olympia, leaving on Sunday, February 12, 11:00 am and returning Monday evening, February 13. Cost is only $10—reserve your seat now by sending a $10 check, payable to IENA, to 222 W Mission, Suite 231, Spokane, WA 99201.

In addition to reserving your seat on the IENA bus, be sure to check the WSNA website at www.wsna.org/legday/ for registration and hotel information.

CE Event “Alternative Therapies” Tuesday, March 6, 2012 Mukagawa Commons This dinner / CE event will be held at Mukogawa Commons, 4000 W Randolph Road in Spokane. Check the IENA website at www.spokanenurses.org for registration and CEARP info.

WSNA presented a free continuing education event on October 25th at the Davenport Hotel in Spokane. Topics included “The Culture of Safety,” again correlating Join us in honoring nurses during with social media issues. A presentation National Nurses Week in the Skyline on “Licensing Issues” was given by a Ballroom at the Red Lion Hotel at the member of the Washington State Board Park. This special event includes dinner, of Nursing. Both topics were timely and scholarship and award presentations, and educational, and considering a 5-star meal a keynote speaker. If you would like to was included­­—what more could we ask apply for a scholarship, go online to http:// for? spokanenurses.org/scholarship.htm. To nominate a colleague for an award, visit Louanne Hausmann attended the WSNA our website at http://spokanenurses.org/ Provider Unit Update on November 11th in IENAAWNF10.pdf.

Seattle. The keynote speaker was Zandra Ohri from the Ohio Nurses Association. ❱❱ If you would like to be notified of upcoming IENA We learned more about the CEARP proevents, please contact us at iena@aimcomm.net. cess as it relates to Provider Units, Faculty Directed Programs, and Independent WSNA Activities Study—such a wonderful educational opportunity. Nurses from diverse backWSNA has been very active this year, and grounds were present and each provided it has been a privilege to attend some of a wealth of information. Since it was Vettheir events. The Biennial Convention erans Day, all veterans in the room were was held in April—what an exceptional asked to stand and were honored with event! Several classes on “Social Media” an ovation. were presented the day before the convention began, and it was a real eye opener.

The IENA is presently working to develop Nursing personnel can inadvertently get a more robust newsletter. In an effort to into trouble by “innocent” postings on reach out to other professional nursing Facebook, Twitter, and even their own organizations in the Inland Empire, we cell phones. The best way to put it, “If you are promoting IENA, WSNA, and other do not want the information on the front organizations’ professional workshops. page of the New York Times or have to We now feature the segment “WSNA and explain it to your mother, don’t put it into Your Board Members” informing our cyberspace.” During the convention, there members of the Board’s involvement with were many opportunities to network with different WSNA committees. We added colleagues from all over the state and from a “Needs Assessment” to the newsletter diverse backgrounds and work areas. Just and are including pertinent articles from imagine actually having input into resoluvarious members. No input is too small! tions and having your voice heard—that is We are also working with our webmaster just what occurred! Freedom of speech is to update our Facebook page. such a powerful tool. Keep your calendar open for spring 2013, when the next con- Welcome to another exciting and eventful vention is planned, and you do not need year, from your Inland Empire Nurses to be a BOD member to attend.

Association!

Annual Spring Gala Tuesday, May 8, 2012 Red Lion Hotel at the Park

The Washington Nurse | Winter 2012 | 13

Nursing Practice News

Coalition Forms to Implement ‘Future of Nursing’ Recommendations Since the release of the Institute of Medicine (IOM) report, The Future of Nursing (FON): Leading Change, Advancing Health, in October 2010, staff from WSNA, the Council of Nurse Educators of Washington State (CNEWS), the Northwest Organization of Nurse Executives (NW-ONE) and the Nursing Care Quality Assurance Commission (NCQAC) have worked together with the staff of the Washington Center for Nursing (WCN) to ensure that Washington State is actively involved in the national efforts to implement the report’s recommendations.

The FON report includes four key messages and 8 recommendations. The key messages are: 1. Nurses should practice to the full extent of their education and training.

2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.

4. Effective workforce planning and policy making require better data collection and an improved information infrastructure.

The Robert Woods Johnson Foundation (RWJF), in collaboration with AARP, is coordinating the work nationally through what they are calling a Campaign for Action (CFA). RWJF required that there be both a nursing organization and a nonnursing organization as co-leads in order for a State to be part of the CFA and to be

recognized as a Nursing Action Committee (NAC). Although RWJF is not providing any direct funding for the NACs, they are providing technical assistance and training to the co-lead organizations’ staff in each of the designated NAC states.

The Washington Center for Nursing (WCN)—of which WSNA is a founding member—is the nursing co-lead organization for the Washington Nursing Action Coalition (WNAC). The Washington Health Foundation (WHF) is the nonnursing organization co-lead.

WNAC planning is underway and being coordinated by a steering committee of WCN and WHF staff with staff representatives from WSNA, NW-ONE, CNEWS and the Nursing Commission. A larger statewide stakeholder advisory committee with representation from both nursing and non-nursing organizations is also under development. The WNAC Steering Committee will oversee the WNAC work which will focus on developing a strategic plan for implementation of the recommendations that includes identifying the key focus work for Washington State, capturing best practices, determining research needs, tracking lessons learned and identifying replicable models.

ARNPs are fully authorized as independent practitioners and there is no requirement for supervision by, or joint practice with, a physician in Washington.

As a result, the WNAC Steering Committee has identified Recommendations 2-7 of the IOM Report for the initial WNAC focus: • Expand opportunities for nurses to lead and diffuse collaborative improvement efforts • Implement nurse residency programs • Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020 • Double the number of nurses with a doctorate by 2020 • Ensure that nurses engage in lifelong learning • Prepare and enable nurses to lead change to advance health By 2012, the Regional Action Coalition (RAC) approach is expected to move into all 50 states.

This work will build on the many successes that Washington State has already achieved over the years. For example, Washington State is a leader in the country and has an excellent track record of steady and persistent progress for advanced practice nursing. These efforts culminated in successfully achieving legal authority for ARNPs in Washington to have fully autonomous practice that includes full prescriptive authority, including Schedule II-V drugs. Under the Washington State Nurse Practice Act,

❱❱ Follow the progress of the WNAC activities and learn how to get involved at www.wacenterfornursing.org/current-projects/nurse-of-the-future/

14 | The Washington Nurse | Winter 2012

Nursing Practice Liability

New NSO Study on Nurse Liability: Important Implications for Your Practice Nurses Service Organization (NSO), WSNA’s endorsed nursing liability insurance provider, recently completed a report entitled Understanding Nurse Liability 2006-2010: A Three-part Approach. The following highlights some of the findings.

Part 1: Five-year Closed Claims Analysis Between 2006 and 2011 there were 516 nurses’ claims closed with indemnity payments exceeding $10,000 (monies paid on behalf of an insured nurse in the settlement or judgment of a claim). These claims excluded those of advanced practice nurses (ARNPs) as that study will be completed this next year. 91.9% of the claims concerned RNs, whereby only 8.1% concerned LPNs. The average paid indemnity totaled $168,438 with an additional average of $43,051 expense paid to cover the investigation and management of the claim for a total average cost of $211,489.

These costs excluded expert witness expenses, attorney fees, court costs and record duplication expenditures.

The specialties with the highest average paid indemnities were obstetrics, neurology / neuro-surgery, and plastic / reconstructive surgery. The highest percentage of closed claims occurred in medical / surgical, gerontology and obstetrics specialties. Findings showed 40.1% of closed claims were in the adult medical / surgical specialty suggesting that a large portion of these nurses may be insured through NSO and not necessarily that such nurses are more likely to be sued.

ANALYSIS OF SEVERITY BY NURSE SPECIALTY FIGURE 1 Severity by Nurse Specialty (Closed Claims with Paid Indemnity of ≥ $10,000)

Nurse specialty

Percentage of closed claims

Total paid indemnity

Average paid indemnity

Obstetrics

10.3%

$20,264,713

$382,353

Neurology / neurosurgery

0.6%

$1,137,000

$379,000

Plastic / reconstructive

0.8%

$1,297,500

$324,375

Pediatric / adolescent

2.7%

$3,486,250

$249,018

Behavioral health

1.7%

$1,367,500

$151,944

Correctional health

3.1%

$2,315,208

$144,701

Adult medical / surgical

40.1%

$29,801,615

$143,969

Emergency / urgent care

9.7%

$7,091,584

$141,832

Public / community health / hospice

8.9%

$6,368,790

$138,452

Gerontology – in aging service facility

18.0%

$9,327,317

$100,294

Aesthetic / cosmetic

3.7%

$821,875

$43,257

Other*

0.4%

$55,000

$27,500

Overall

100.0%

$83,334,352

$161,501

[* “Other” include a certified insulin pump trainer and an administrative county-employed nurse who reviewed state Department of Health nursing home recommendations.]

ALLEGATION BY CATEGORY • Claims involving scope of practice had the highest average paid indemnity, perhaps because practicing outside the scope of one’s professional license is perceived as egregious misconduct. Claims with allegations related to scope of practice are thus difficult to defend successfully as illustrated by the following examples: • An RN instructed an LPN to administer medication via intravenous bolus injection which was outside the LPN’s scope of practice and facility policy. The patient suffered a stroke as the bolus was being administered resulting in irreversible neurological damage and permanent right sided hemiparesis.

• A nurse removed and replaced an aging services resident’s gastric tube without practitioner orders and without notifying the practitioner. The patient suffered severe infection, sepsis and subsequent death from respiratory arrest.

• Allegations related to patient assessments and monitoring were relatively common and resulted in high average paid indemnity. The highest average paid indemnity regarding assessment involved delayed or untimely patient assessment. 70.8% related to the nurse’s failure to properly or fully complete the assessment or to assess the need for medical intervention.

• Allegations related to treatment / care accounted for the highest percentage of closed claims. These included failure to timely respond to patient concerns, failure to respond to

The Washington Nurse | Winter 2012 | 15

Nursing Practice Liability

equipment warning alarms, failure to invoke or utilize the chain of command, and delay in implementing practitioner orders or notify the practitioner of changes in the patient’s condition.

• The average paid indemnity for closed claims involving medication administration is lower than allegations related to scope of practice, patient assessment, monitoring and treatment / care. Administration of the wrong medication had the highest average paid indemnity.

• Documentation deficiencies are contributing factors in many nurse professional liability claims, but documentation was the primary allegation in one closed claim. The documentation claim shown below resulted from the complete absence of any form of documentation for an incident in which a nurse removed a tick from the patient’s skin in a hospital emergency department. The nurse did not register the patient and created no records regarding the patient’s treatment. This absence of documentation was a causative factor in the patient’s subsequent death as no practitioner was aware that the patient had undergone a tick removal.

The diagnosis and treatment of the infection resulting from the tick bite was delayed resulting in unsuccessful treatment.

FIGURE 2

Severity of Allegation Category

Allegation category related to

Percentage of closed claims

Total paid indemnity

Average paid indemnity

Scope of practice

1.7%

$ 2,664,100

$296,011

Assessment

12.6%

$14,867,925

$228,737

Monitoring

6.8%

$ 7,814,875

$223,282

Treatment / care

58.5%

$47,370,806

$156,857

Medication administration

14.7%

$ 8,593,330

$113,070

Abuse / patient’s rights / professional conduct

5.4%

$ 1,992,066

$ 71,145

Documentation

0.2%

$ 31,250

$ 31,250

Overall

100.0%

$83,334,352

$161,501

embolism. In some of the closed claims patient death was associated with a single injury or acute illness. However, of the 44% of closed claims where cardiopulmonary arrest was the ultimate cause of death, many involved patients whose clinical course included a series of illnesses, injuries and symptoms occurring over a period of time, which contributed in varying degree to the patient’s overall decline.

CONCLUSION This analysis of nurse professional liability closed claims reveals that nurses continue to be held strictly accountable for acting within their scope of practice according to their license, as well as within the policies and procedures of their place of employment.

Many claims develop due to a failure involving core competencies such as patient assessment, monitoring, treatment and care, practitioner and patient communication, timely and complete documentation, and invocation of the chain of command – all of which are essential to ensure quality patient care in a safe environment. The claims also demonstrate that nurses are expected to serve as the patient’s advocate and are responsible for obtaining alternative practitioner intervention if the initial practitioner does not respond appropriately to patient’s medical needs.

Another lesson reinforced by the data is the need for timely, ongoing, two-way communication between the nurse and other members of the healthcare team. All communication, either spoken or written, must be fully documented in the patient’s health information record, providing the information needed to make sound clinical decisions. Documentation should clarify the decision-making process and support discharge planning and other activities implemented on behalf of the patient by nurses, physicians and other professionals.

Risk Control Recommendations • Know and comply with your state scope of practice, nurse practice act and facility policies, procedures and protocols.

• Follow documentation standards established by professional nursing organizations and comply with your employer’s standards.

• Develop, maintain and practice professional written and spoken communication skills.

SEVERITY OF INJURY Death was the most common injury accounting for 48.5% of all closed claims. The three causes of death with the highest paid indemnity were cardiac injury, loss of organ function, and 16 | The Washington Nurse | Winter 2012

• Emphasize ongoing patient assessment and monitoring.

• Maintain clinical competencies relevant to the patient population and healthcare specialty • Invoke the chain of command when necessary to focus attention on the patient’s status and / or any change in condition.

Nursing Practice Liability

Part 2: Nurse License Protection on Paid Claims During this same five year period there were 1,127 license defense paid claims in which legal counsel defended nurses against allegations that could potentially have led to the revocation of their license. 84.5% of such claims were paid for RNs and 15.5% were paid for LPNs. RNs who experienced a license defense paid claim worked most often in a hospital setting (57.3%) followed by aging services facilities and home health services. The most common allegation was professional conduct (23.5%). Other areas of allegation included improper treatment / care, medication administration errors, abuse / patient’s rights, documentation error or omission, scope of practice, assessment, and monitoring.

Within the professional conduct category, drug diversion and / or substance abuse was the top allegation for both RNs and LPNs. Allegations concerning improper treatment / care often reflected miscommunication or lack of communication with a provider, other nurse or inadequate hand-off of a patient to another practitioner. Administering a wrong medication was the most frequent medication error followed by improper technique.

For the majority of claims (50%) no action was taken against the nurse’s license while 45.2% of the outcomes involved monitoring the nurse’s practice, requiring further education or issuing a caution. In addition, 4.8% of the decisions involved licensure surrender or revocation, terminating the careers of these nurses.

A nursing board complaint can be filed against a nursing license by a patient, patient’s family member, colleague or employer.

By knowing the most common types of allegations filed, nurses can identify their vulnerabilities and take appropriate action to protect their licenses.

Effective risk control strategies include: • working to improve communication and interpersonal skills

Part 3: Nurse Work Profile Survey The purpose of this survey was to examine the relationship between professional liability exposure and a variety of demographic and workplace factors. To that end, the responding nurses were divided into two groups: those who had experienced a professional liability claim resulting in loss that had closed between 2006 and 2010, and those who had never experienced a claim. Two similar survey instruments were distributed to NSO-insured nurses with and without claims.

SUMMARY OF FINDINGS The initial sample for the survey consisted of 1,617 nurses who have submitted a professional liability claim within the past 5 years, and 7,475 nurses who had no claim filed. The response rate was 20% (n = 294) for those with a claims history, and 12% (n = 820) for those with no claim. The current nursing licensure held was that of an RN for 92.1% for those with a history of a claim, and 87.7% for those without a claim.

Despite only 11.3% of claimants working for at least two different employers at the time of the incident, this seems to have contributed to an increase in average payment.

Q: How many different employers do you currently work for?

CLAIM SEVERITY

$25,000 $20,000

$21,038

$15,000 $10,000

$15,259 $12,963

$5,000

• knowing and adhering closely to facility policies • maintaining nursing skills / competencies through continuing education efforts

One (n=218)

Two (n=30)

Other (n=17)

• ensuring thorough and accurate documentation in patient care records

The Washington Nurse | Winter 2012 | 17

Nursing Practice Liability

Education contributed to the average paid indemnity amount as payments were higher for claims from respondents who had completed a nursing diploma program than for respondents with a bachelor’s or associate’s degree.

The highest percentage of closed claims involved respondents who had worked more than 21 years as a nurse. Analysis of claim severity showed a positive correlation between the amount paid and the number of years in the profession.

Continuing Education Required Credits CLAIM SEVERITY

$25,000

Number of Years in Profession

$26,620

$20,000

CLAIM SEVERITY

$17,655

$15,000

$25,000

$15,623

$16,938 21 years (n=129)

$19,947 16-20 years (n=62)

11-15 years (n=26)

$16,602 6-10 years (n=34)

3-5 years (n=15)

$7,048 1-2 years (n=9)

<1 year $5,631 (n=1)

$10,000

$11,456

$15,000

$19,994

$10,000

$20,000

$5,000

State-required continuing education licensure requirements were associated with decreased average paid indemnity. As the number of required credits for such increased, the average paid indemnity decreased.

Obstetrics and perinatal practice areas had a significantly higher proportion of nurses with claims. The highest paid claims came from the practice areas of occupational health, followed by psychiatric / behavioral health, and adolescent care.

Respondents who did not have a mentor or preceptor during their first two years as a nurse experienced higher average paid indemnities than those who did.

$10,655

$5,000

None (n=60)

<30 (n=107) 30 60 (n=108) Other (n=13)

The existence of an organization / facility policy for disclosing mistakes resulted in a 50% decrease in the average paid indemnity. A quarter of respondents state their facility did not have a policy in place for disclosing mistakes, and a third stated they did not know if such a policy existed.

Q: Does your employer have a policy around the disclosure of mistakes?

CLAIM SEVERITY

$35,000

$34,707

$30,000 $25,000 $20,000 $15,000

$17,255

$16,204

$10,000 $5,000 Yes (n=112)

18 | The Washington Nurse | Winter 2012

No (n=68)

Not sure (n=85)

Nursing Practice Liability

Interaction with management was associated with decreased average paid indemnity. Respondents who noted they felt comfortable turning to management for help had a lower average paid indemnity than those who did not.

Q: Describe your level of interaction with your manager / supervisor when you experience a problem at work.

In other words, did you feel comfortable asking for help?

CLAIM SEVERITY

Conclusion It is important that nurse be aware of these study findings and that they take to heart the recommendations: • Know and comply with your state scope of practice, nurse practice act and facility policies, procedures and protocols.

• Follow documentation standards established by professional nursing organizations and comply with your employer’s standards.

• Develop, maintain and practice professional written and spoken communication skills.

No, I was afraid to contact mgmt (n=7) $42,276

• Emphasize ongoing patient assessment and monitoring.

• Maintain clinical competencies relevant to the patient population and healthcare specialty

No, I was unable contact mgmt (n=20)

• Invoke the chain of command when necessary to focus attention on the patient’s status and / or any change in condition.

$16,735

Yes, I use the chain of command (n=201)

NSO will be posting this full report on their website at www.nso.com.

$15,181

— By Sally Watkins, PhD, RN $10,000

$20,000

$30,000

$40,000

Please Note: NSO will be raising their rates for nurse liability insurance premiums: •

Full-time employed nurses in WA will increase by 8% to come up to $106 / year

•

Part-time employed nurses will also increase to $106 / year

•

Self-employed full-time nurses will receive a 10% increase, to $380 / year

•

ARNPs will receive a 9.7% increase, to $789 per year

For more information, contact: Kate Mager, Account Manager, Aon Affinity, kate.mager@aon.com , 215.773.4118

Important Implications for Creating a Culture of Safety WSNA has launched a major education and outreach initiative for our members about the importance of creating a Culture of Safety in health care workplaces. We have also joined with other professional organizations, including the Washington State Hospital Association (WSHA) and Association of Nurse Executives (AONE) to raise these important topics with employers and administrators. We will be taking our education session on the road and online, with classes across the state in the coming months. The Washington Nurse will also continue to feature safety topics throughout the year. Visit www.wsna.org/Topics/Patient-Safety/Culture/ for more information.

The Washington Nurse | Winter 2012 | 19

Nurses at St. Joseph Medical Center in Bellingham Battle for Respect and a Voice in Patient Care

N

urses at St. Joseph Medical Center in Bellingham have won a hard fought struggle to make their voices heard. In a proposed restructure, hospital management planned sweeping changes while ignoring nurses’ input on issues that impact their work at the bedside. Over several months, nurses escalated their actions and demands for respect culminating in a public rally with several hundred nurses, community members and other labor unions.

The proposed restructure would include switching almost every nurse in the hospital to eight hour shifts. The decision was reached without meaningful input from the nurses at the bedside and management was planning to move forward unilaterally with implementation. WSNA was

active in organizing the nurses’ efforts and pushing management to reevaluate their plans before making drastic changes that would affect nurses’ professional and personal lives. After several meetings between nurses, WSNA and management, there was no significant progress and we brought this issue forward to the public with a newspaper ad and public rally.

Speakers at the rally emphasized that inadequate staffing is the safety concern that needs to be a top priority, rather than the cost-driven restructure the administration was proposing. The nurses also used the rally to launch a petition for community members to sign in support of the nurses and their efforts to have a voice in hospital decisions affecting patient care.

Attendance at the rally and participation

20 | The Washington Nurse | Winter 2012

in the survey clearly demonstrated the surge of public support for the St. Joseph’s nurses.

In response to the nurses’ efforts and growing publicity of this issue, management decided to back off their initial plan to act unilaterally. The hospital CEO scheduled several forums for nurses to provide input and used those sessions to create a new course of action. St. Joseph’s remains committed to reducing caregiver fatigue, but has resolved to seek nurse input, including using the established Nursing Councils at the hospital, before developing any further plans that affect nurses’ working conditions. This is a clear victory for the nurses at St. Joseph Bellingham and a testament to the unity and hard work of the local unit and WSNA.

Labor Relations News

‘ADO’ Form Helps Nurses Document Unsafe Conditions

Types of Situations Where You Should Complete an ADO Form • Charge nurse is unable to perform charge nurse duties, secondary to increased patient care assignment

WSNA is happy to introduce a newly designed “Assignment Despite Objection” (ADO) form that is easier to use and fill out.

• Inadequate nurse to patient ratios for patient acuity based on your clinical judgment

If you find yourself in a situation that you believe creates unsafe conditions for patients or for you, you should complete an ADO Form as soon as possible.

• Insufficient support staff requires you to assume additional duties • You are not trained or experienced in the area assigned

By completing the form, you will help make the problem known to management, creating an opportunity for the problem to be addressed. Additionally, you will be documenting the facts, which may be helpful to you later if there is a negative outcome.

• You have not been oriented to this unit / case load • Patient care equipment missing or unusable • Necessary equipment is not available (e.g.: supplies, IVs, medication availability) • You are not trained or experienced to use equipment in assigned area

WSNA also uses your ADO forms to track the problems occurring in your facility. When you and your coworkers take the important step of filling out an ADO form, you are helping to identify whether there is a pattern of unsafe conditions for you or your patients at your facilities. This information is used by your conference committee, staffing committee, and WSNA labor staff to improve your working conditions.

• System failure (e.g.: computer, phone, pyxis, call system) • An assignment poses a serious threat to your health and safety • An assignment poses a serious threat to the health and safety of a patient under your direct care • Forced / Mandatory Overtime • Missed breaks

❱❱ Find the form at www.wsna.org/labor/ado

Labor Relations Report Card The current economic environment continues to make negotiations challenging for collective bargaining units throughout the state. WSNA negotiation teams, nurse representatives and attorneys have worked hard to achieve fair contracts, with continued positive results.

Wage Increase

Peace Health Southwest Medical Center

Skagit Valley Hospital Holy Family Hospital

By participating in the collective bargaining process, WSNA members are standing together and continuing to demand strong contract language, that holds employers accountable.

We are proud of our successes and will continue to hold the line, fighting for fair and equitable contracts that promote the interests and welfare of WSNA-represented nurses.

Key Gains

1st Year

1.5%

●● Annual Step increases up to 30 years

●● BSN/MSN premium of $1.00 per hour starting 2011

2nd Year

2.0%

●● Charge pay increased to $2.50

●● Bereavement leave increased from 24 to 36 hours

3rd Year

2.0%

per hour starting 2012 ●● Preceptor pay increased to $ 1.50 per hour starting 2012 ●● Local Unit officer or designee may be present

1st Year

Parity

2nd Year

0.5%

3rd Year

0.5%

at all steps of the grievance process

1st Year

2.0%

●● Step 18 increased, Step 19 added

2nd Year

2.5%

●● Job postings and applications

3rd Year

1.5%

will now be done online

●● Nurses working 10 or 12 hour shifts must have

10 hours rest between shifts or be paid time and a half for all hours worked without such rest ●● Improved Low Census and Low

Census Standby Language ●● Eligibility for insurance reduced

from 24 to 20 hours per week

Sunnyside Community Hospital

1st Year

0.5%

●● Float Premium pay of $2.00 per hour

●● Relief Charge Nurse Pay increased to $1.75 per hour

2nd Year

0.5%

●● Unit Resource Nurse premium

●● Clarification of Charge Nurse and

3rd Year

0.5%

of $2.00 per hour

Preceptor assignment language

The Washington Nurse | Winter 2012 | 21

Legislative Affairs Campaign for Patient Safety

MOUNTING A

Campaign Patient Safety FOR

A

s nurses, we know that appropriate staffing protects patients from preventable medical errors, injuries and deaths. Studies show that registered nurses intercept 85% of medical errors before there is harm to the patient. Quality nursing care can mean the difference between life and death, yet the volume and complexity of patient care continues to grow without adequate precautions in place to protect nurses and patients from the dangers of fatigue.

We are all out of patience and the hospitals are out of time!

Campaign for Patient Safety

WSNA has worked in the Legislature, in collective bargaining, in the courts, and in good-faith negotiations between the hospital association and health care unions to ensure adequate staffing levels and safe patient care. Despite claiming economic hardship, the hospitals continue to focus on new buildings and expansions without any meaningful commitment to ensuring that nurses are not overworked and fatigued.

We have heard our members loud and clear. There is outrage over the ineffectiveness of the hospital nurse staffing committees, there is frustration with the ongoing fight to get uninterrupted meal and rest breaks, and there is anger over the increased use of pre-scheduled call to bypass the mandatory overtime law.

22 | The Washington Nurse | Winter 2012

Now is the time for bold action. We cannot allow hospitals to continue prioritizing profits over patients.

In response to this growing health crisis, WSNA is launching a new Campaign for Patient Safety to ensure safe nursing care for our patients. The campaign is comprised of three legislative bills to ensure Safe RN Staffing, uninterrupted meal and rest breaks, and an expansion of protection against mandatory overtime.

We know the hospitals will fight us every step of the way, but we cannot allow them to speak for us or for our patients on these important matters. WSNA is prepared to dedicate every resource to this battle for as long as it takes to win the real improvements we need in patient care. However, it is you—the members of WSNA—that are our greatest asset in this campaign. Legislators and the public need to hear from nurses about why these issues are so critical to patient safety.

This campaign will require hard work and dedication from all of us, but we simply have no other choice It is time for Safe Staffing Now!

The Washington Nurse | Winter 2012 | 23

Legislative Affairs Campaign for Patient Safety

N

ursing care is complex and often delivered in an intense environment. The job requires continuous patient assessment, critical thinking, expert judgment, advocating on behalf of our patients, and educating patients and their families. An aging population, advances in technology and declining lengths of stay have steadily increased patient acuity in hospitals yet nursing is often still treated as a cost center rather than a hospital’s greatest asset.

WSNA’s Campaign for Patient Safety is dedicated to: • Better, safer care • Stronger retention of nurses • Reduced health-care costs The Campaign is a comprehensive effort that will draw on every resource and staff member at WSNA. We are committed to ensuring that every patient receives quality and safe nursing care.

Establishing Safe Staffing Standards In 2008, WSNA was proud that years of advocacy and outreach paid off with the passage of Safe Nurse Staffing Legislation (House Bill 3123). We knew that the law was not perfect, but were willing to work with hospital administrators in an attempt to give staff nurses meaningful input into staffing decisions at each hospital. The law mandated that every hospital establish a nurse staffing committee composed of at least half direct care nurses. This committee was tasked with developing, overseeing and evaluating a nurse staffing plan for each unit and shift of the hospital. The law was designed to provide opportunities for meaningful input from nurses, but the hospital administration and CEO still retained final authority on all staffing level decisions Since the passage of this legislation, WSNA has worked with the other health care unions (SEIU and UFCW) in collaboration with the Northwest Organization of Nurse Executives (NWONE) and the Washington State Hospital Association (WSHA) on the successful implementation of the staffing law and negotiations on improvements to the existing laws on safe staffing, meal and rest breaks, and mandatory overtime. These mediated sessions included a total of 43 meetings and 545 hours of meeting time since 2008. Unfortunately, despite unprecedented efforts by all parties to reach an agreement, we were unable 24 | The Washington Nurse | Winter 2012

Legislative Components of the Campaign WSNA is pushing three bills forward in the Legislature in collaboration with other healthcare unions, labor organization and consumer groups.

Each bill addresses a core patient safety concern and seeks to establish statewide safety standards to protect patients and nurses.

N E W STAT E W I D E STA F F I N G M I N I M U M S FO R S A F E R PAT I E N T C A R E Despite good-faith efforts to encourage hospitals to adopt safer staffing levels to address the staffing disparities that put patients, nurses and other healthcare professionals at risk, hospitals have failed to make measurable, meaningful changes.

It’s time the State steps up and holds hospitals accountable for this dangerous trend in health care.

Requires the Department of Health (DOH) to establish statewide minimum nurse staffing standards with input from registered nurses and patient safety experts Mandates hospitals to include staff nurses in the development of staffing plans. Hospitals can leverage existing staffing committees to review criteria such as census, intensity of patients and personnel skill mix to develop plans Mandates nurses receive orientation prior to assignments to new units or clinical areas Mandates hospitals collect and disclose data related to nursing patient outcomes such as nurse staffing levels and nursing hours per patient day Gives patients access to more data to make informed choices about the quality of their care Requires DOH to investigate complaints related to inadequate nurse staffing Mandates hospitals who violate staffing minimums correct staffing practices and face a potential civil penalty of $10,000 for each violation

Legislative Affairs Campaign for Patient Safety

to do so. We know that we can’t wait any longer to act on these important issues.

U N I N T E R R U P T E D R E ST & M E A L B R E A K S Federal regulations prohibit pilots and truckers from flying and driving fatigued.

But thousands of nurses and other healthcare professionals are forced to deliver complex, demanding care to patients in emotionally-charged hospital environments without an uninterrupted break.

Nurses and healthcare professionals must be vigilant and focused to oversee an array of duties for up to 12 hours or more without an uninterrupted break. These duties include: administering complicated pharmaceutical prescriptions and treatments, constant assessment and evaluation of patient treatments and conditions, and initiating life-saving emergency procedures.

Mandatory uninterrupted breaks for nurses and healthcare professionals who deliver direct-patient care Hospitals retain the right to determine break times and exceptions to the law to deliver critical patient care around emergencies and disasters Requires hospitals to track missed breaks Prohibits hospitals from retaliating or firing nurses and healthcare professionals who report missed breaks Institutes a potential financial penalty for knowing violations

L I M I T I N G M A N DATO RY OV E RT I M E Nursing and staffing shortages have forced nurses and other healthcare professionals into mandatory overtime or risk losing their jobs. The current State law for hospital nurses has a loophole that allows hospitals to use pre-scheduled call as a thinly veiled replacement for mandatory overtime.

Nurses and other healthcare professionals are being forced to work long hours without adequate rest. This causes fatigue and contributes to increased risks of patient safety.

Requires hospitals to apply mandatory overtime laws to prescheduled on-call duties so they are not abused to resolve chronic staffing shortages Expands overtime protections to jails and State veterans’ homes Expands overtime protections to other healthcare professionals charged with direct-patient care

We do not have a single example of a successful nurse staffing committee operating in any of our hospitals where staff nurses have truly meaningful input into ALL nurse staffing decisions. While the unions and management organizations were able to collaborate on training efforts around the staffing law and the tools in developing staffing plans, we have been unable to reach WSNA’s goal of giving staff nurses meaningful input into staffing decisions to ensure safe and quality patient care. We have numerous examples where the staffing committees’ recommendations are ignored, vetoed or altered without any feedback or input from the committee. In fact, during this recession, we have seen an increase in hospital restructures and layoffs, yet none of these processes included the nurse staffing committees.

Ensuring Uninterrupted Meal & Rest Breaks In addition to concern about staffing levels, WSNA has been leading this state and this country in education about fatigue and the impact on patient care.

Ensuring that nurses receive full, uninterrupted rest and meal breaks has been a top priority for WSNA for the past several years and remains a top priority for WSNA. Since 2007, we have taken every opportunity to work with the Department of Labor and Industries to change regulations that prevent uninterrupted meal and rest periods. Despite launching a powerful public campaign and moving the bill through the House, we were unable to pass meal and rest break legislation in 2010. In 2011, we began a mediated negotiation process working with the other health care unions and WSHA to address the issue of nurse fatigue and the impact of missed rest and meal breaks.

Since May, 2011, we had 12 meetings for a total of 43.5 hours. While we reached a common ground on certain concepts such as the need for uninterrupted meal and rest breaks, we were not able to reach agreement on the details of the policy.

WSNA has also taken this battle to the legal system and to the negotiation table in our collective bargaining agreements. We have filed suit and settled with two hospitals regarding missed breaks, have three lawsuits pending, and won arbitration at one hospital.

We also continue to educate our members and other The Washington Nurse | Winter 2012 | 25

Legislative Affairs Campaign for Patient Safety

health care professionals and professional organizations about the connection between meal and rest breaks and the dangers of fatigue.

Limiting Mandatory Overtime The passage of the 2002 landmark legislation to prohibit mandatory overtime for nurses was a huge victory. The law allowed for prescheduled on-call which has become a loophole for employers.

Unfortunately, over this past decade, we have witnessed an increase and expansion in the use of prescheduled on-call by employers as another means of mandatory overtime. Nurses sign up for call in order to respond to unanticipated patient care emergencies.

Reports from our members show that on-call is being used instead for elective or nonemergency surgeries, and to fill chronic staffing shortages such as vacations and longstanding holes in the schedule.

The current law also requires that nurses not leave during an ongoing procedure at the end of his / her shift. However, many employers are using that provision to schedule nonemergency procedures towards the end of a nurse’s shift knowing that it will require overtime.

In addition, certain settings such as jails and State Veteran’s Homes were excluded from the current law.

The patients and nurses in those settings deserve the same protection.

We are working to end inappropriate use of prescheduled on-call in order to meet the intent of the law. Limiting mandatory overtime prevents fatigue among nurses and supports safe patient care.

Stand up for Safe Patient Care L E G I S L ATO R S N E E D TO H E A R F R O M YO U !

We need to ensure that the public and lawmakers hear from registered nurses, the trusted experts at the bedside and in patient care, not hospital administrators. You will continue to receive regular updates from WSNA in your email, on our website and in The Washington Nurse about how the campaign is progressing and what you can do to get involved. We need your voice!

Plan to attend Nurse Legislative Day on February 13th and speak with your Legislators in the afternoon.

Use WSNA’s automated email system to send your Legislators a message—be sure to include a personal story or perspective!

Mail a letter to your Legislators.

Call your Legislators and tell them about the campaign and why these bills are so important.

Visit www.wsna.org to get the latest information and list of legislative activities that you can participate in to help move the Campaign for Patient Safety forward.

Visit Olympia any week day during session. WSNA staff will work with you set up meetings with your Legislators or their staff.

Attend a WSNA meeting in your area to participate in advocacy activities. We are scheduling dinners, hot chocolate socials and other local activities, including driving a special WSNA Mobile Action RV to hospitals across the state with all the resources you need to take action on this issue! ❱❱ Contact Richard Burton, WSNA Political Action Coordinator at rburton@wsna.org or (206) 575-7979, Ext. 3019 for more information about how to get involved.

26 | The Washington Nurse | Winter 2012

Legislative Affairs Budget Crisis

Update: Budget Crisis Persists As reported in the last issue of The Washington Nurse, the Legislature convened a special session in November lasting 30 days. They were tasked with creating a supplemental budget to close a nearly $2 billion dollar gap in funding through June 30, 2012. The Governor proposed a preliminary budget that included drastic cuts to critical health programs like the Basic Health Plan, but also released a later budget proposal that included new revenue to offset some of the cuts. WSNA fully supports revenue options that allow this state to have a fair, balanced budget. During special session, WSNA was active in the legislature with members, our staff and lobbying team (see side bar for a list of recent legislative activities).

Unfortunately, very little progress was made in the special session, with Legislators only agreeing on approximately $500 million in cuts. Now Legislators must close the remaining $1.5 billion budget gap over the 60 days of the regular legislative session. Many organizations, including WSNA, are urging Legislators to pass a revenue package so that we don’t enact another all-cuts budget that continues to shrink the health safety net for some of our most vulnerable populations.

WSNA and our members have spent the past several years fighting to maintain funding for critical programs like the Apple Health Children’s Health Program, Basic Health Program, Disability Lifeline, Maternity Support Services and public health funding. Through our hard work, many of these programs have been saved from the chopping block, but unfortunately they are jeopardized again and we are seeing an evergrowing list of endangered programs.

It is clear that there is just nowhere to cut that would not have grave conse-

quences for the individuals served by these programs but also for the health of our communities as our public health system struggles to keep up with growing demands.

There is also growing concern about the nursing workforce and our ability to handle the needs of the public if we are unable to boost the number of graduates from nursing programs.

An expected 23% of nurse educators will retire before 2013. At the current capacity of our schools, by 2017 the supply of nurses will not be enough to demand. By 2031, we are projected to be 12,000 registered nurses short of what we need. Budget cuts have hurt the ability of schools to attract nursing faculty and have not allowed for needed expansions in program size. Only one out of two eligible students are accepted by nursing programs due to capacity.

Many potential students are also being squeezed with ever-increasing tuition that is closing the door to opportunity for these prospective nurses.

Another all-cuts budget hurts our families and jeopardizes economic recovery. Washington used to be a leader in innovation because we made a deliberate choice to invest in schools, jobs, and safe, healthy communities through public health. Now more than ever, we need investments in schools, healthcare, public health, and local community services that will create jobs. It does not make sense to continue to cut the state budget without raising revenue in fair and equitable ways.

We need your voice in Olympia to tell Legislators what budget cuts will mean to you and your patients! Find out how to get involved at www.wsna.org.

I M PAC T O F T H E C U T S

Nursing Education

By Chris Nelson, a nursing student at Seattle Central Community College and President-Elect of the Nursing Students of Washington State After working a few years on the ambulance as an EMT, I decided to pursue my dream of becoming a registered nurse. Little did I know that tuition and fee hikes would nearly derail me! The first classes I took at Seattle Central Community College were my pre-requisites for nursing school, and I was lucky to receive some financial aid to make my attendance possible.

Then my tuition went up 12%, and the following year an additional 13%. At the same time, my financial aid went down, all due to state budget cuts. Without winning a scholarship from the Washington State Nurses Foundation, I couldn’t have remained in the program.

This upcoming June, after completing my ADN, I am transferring to the University of Washington-Bothell to enroll in the RN-to-BSN program but I don’t know how I’m going to be able to afford it. They’ve announced a minimum 20% tuition rate hike with the expectation that the actual rise in costs will be even higher than that.

UW is already more than three times as expensive as my community college!

I’m excited to be in school to become a nurse. I know I will make it to the finish line, but I’m scared to think of how on earth I’m going to pay for it in today’s economy.

The Washington Nurse | Winter 2012 | 27

Legislative Affairs Budget Crisis

Scope of the Crisis: Over $10 Billion in Cuts Since Recession Began Budget

FY 2009

2009 – 2011 Original

2009 – 2011

2009 – 2011

1st Supplemental 2nd Supplemental

WSNA Political Action 2011 – 2013 Original

$0

Billions of Dollars

-$2

-$0.92

-$1.06

-$1.62 -$2.60

-$4

-$4.05

-$6 Annual Budget Cuts -$8 Cumulative Budget Cuts -$10 Cumulative Cuts $10.25 Billion -$12

Source: Budget & Policy Center calculations; data from LEAP; based on most relevant maintenance levels

The Legislature Addressed Only a Quarter of the Shortfall During Special Session $2.0

$1.6 Billions of Dollars

WSNA’s Special Session lobby day brought members to Olympia to speak to legislators about our budget priorities. Participants included Julia Weinberg, Ed Dolle, Anita and Fred Stull, Charlotte Foster, Tina Maestas, Juan Bocanegra, Leanne McFarland, Andrea Sehmel, Jeanette Cole and her daughter.

$1.2

Remainder of Shortfall* $1.5 Billion Income from Sale of Unclaimed Property $50 Million

$0.8

$0.4

WSNA President Julia Weinberg testified at a House Ways and Means Committee public hearing on the Governor’s Proposed Supplemental Budget and highlighted Maternity Support Services, the Basic Health Plan, and Volunteer Provider Program. She also testified to WSNA’s support for the Governor’s proposed half cent increase in sales tax (which raises only about $500,000), but urged the legislature to do more to raise revenue. Ginny Cassidy-Brinn, an ARNP and nurse educator, supported Julia’s remarks and added concern about cuts to family planning services.

Technical Changes** $97 Million Transfers $106 Million

Julia Weinberg delivered an inspiring speech at the Face of the 99% Rally on the steps of the capitol, organized by the Community Action Network.

Cuts $226 Million

Source: Budget & Policy Center analysis; data from LEAP *

Factors in an ending balance of approximately $600 million

**

Includes changes to caseload, worker’s compensation, utilization and other changes to maintenance levels

Health and Education Have Suffered the Largest Share of Cuts

Healthy People & Environment 35%

Economic Security 6%

Thriving Communities 7%

Education & Opportunity 52%

Source: Budget & Policy Center calculations; data from LEAP

28 | The Washington Nurse | Winter 2012

WSNA members participated in the Children’s Alliance Have a Heart for Kids Day, to support avoiding cuts to Apple Health for Kids and new revenue.

Participating members included Clare Brooks and Jeremy King from Children’s Hospital, Josephine Saltmarsh and Janet Bowen (UW School of Nursing).

Legislative Affairs Budget Crisis

Karen Bowman, WSNA’s environmental health specialist, and Libby Zadra, a former oncology nurse, testified in support of Senate Bill 5594 Hazardous Drugs which would establish minimum requirements for facilities that handle hazardous drugs to protect employees from harmful health exposures such as hospitals, clinics, and pharmacies.

In numerous meetings, WSNA staff and lobbyists testified or submitted written remarks on maintaining funding for Maternity Support Services, cuts to higher education, and several scope of practice issues.

WSNA organized in-district meetings with Legislators prior to Special Session in Spokane with Sen. Lisa Brown, in Bellevue with Sen. Rodney Tom, in Everett with Rep. Mike Sells, and in Seattle with Sen. David Frockt.

WSNA members participating included Lynnette Vehrs, Bobbi Woodward, Louanne Hausmann, Phyllis Zimmer, Marilynn Albert, Deb Stauffer, Barbara Bly, Reggie Voyk, Leta Tarrell, Donna Borgford-Parnell, and Jeremy King.

During Special Session, WSNA organized get-togethers in Spokane, Everett and Vancouver to bring nurses together to write letters to their Legislators.

WSNA participants included Lynnette Vehrs, Sue Glass, Ulrike Kaufmann, Sunday Miletich, Janet Bren, Sylvia Meloche, Bronwen O’Neill, Debbie James, Marva Petty, Vicki Wornath, and Madeleine Ormond

I M PAC T O F C U T S

Maternity Support Services Excerpted from testimony provided by Faith Hammel MN, RN, PHSS, Personal Health Services Supervisor, Public Health – Seattle-King County Maternity Support Services (MSS) is a program that works across time that allows our clients to become independent. The practice of Public Health Nursing is not the episodic care of medicine but the maturing of families to withstand the assault from the outside world. Without the MSS programs, Washington will provide prenatal services but first time moms, teen moms and disadvantaged moms will not receive all the services necessary to support a healthy pregnancy. Our clients do not have built in support systems; they live in chaotic situations and have problems accessing services, Public Health Nursing helps clients learn to manage their own lives. Public health nurses integrate community involvement and knowledge about the entire population with personal clinical understandings of the health and illness experiences of individuals and families within that population.

I would like to share just one client’s story with you. This client discovered she was pregnant at 22 weeks. This is much later than normal for pregnant women to begin prenatal care. She was renting a couch at a friend’s house for $80 a month and had only one shelf of refrigerator space designated for herself. She had been living on top ramen for three days and had no gas for her car. She walked five miles to make her first meeting with me. She had applied for her medical coupon but did not have a doctor.

In that first visit, we found her an OB provider and made an appointment, arranged for her to receive a gas card so she could drive to her appointment, certified her for WIC food benefits so she could have a

healthy diet, signed her up for a smoking cessation program, educated her on fetal development, assessed her for depression and registered her in Childbirth Education classes.

She kept every appointment with me, the social worker, the registered dietition, her OB and she delivered a healthy baby at term. She then continued to attend parenting classes, mom’s support group and when her child was one year old, she applied and got a slot in a job training program to be a transit driver. She did not earn much money the first year, but after she completed her training, she got a full time job with benefits for herself and her child. I continued to see her in the clinic until her child was 5 and no longer on the WIC program. I have stayed in contact with this mom. Her child is now almost an adult, and I know that I helped equip this mom with the tools that she needed to have a successful pregnancy and her daughter has grown up healthy and happy.

This mom knew she needed the tools to put herself on the road to successful parenting but was unaware of all of the assistance that was available to her. My job was to show her the doors, help her knock and to provide support as she outgrew the need for the program.

The Washington Nurse | Winter 2012 | 29

Legislative Affairs Budget Crisis

WSNA Budget Priorities WSNA believes that an all cuts approach to the current budget crisis will further endanger the health and safety of our communities. We urge the Governor and the Legislature to consider all options including new revenue and closing tax loopholes to preserve the safety net infrastructure such as:

PRESERVATION OF KEY HEALTH SAFETY NET PROGRAMS

PUBLIC HEALTH NURSING & PUBLIC HEALTH FUNDING

By denying these services, Washington tax payers stand to experience higher costs due to increased emergency room visits and more expensive treatment of chronic illness that could have been better managed or prevented. WSNA supports preserving the infrastructure of safety net programs including:

Public health nurses and public health departments are the center of a quality health care system and the most cost effective system for disease prevention and health improvement. Washington’s public health system is in jeopardy due to decades of neglect and erosion in public health spending. WSNA supports protection of current funding for local public health capacity and dedicated revenue for public health and public health nursing including programs such as:

The Basic Health Plan With the number of uninsured in Washington at a record high, the BHP is the only affordable option for WA residents who are self-employed or whose employer does not offer coverage. Although the age of participants have increased, the BHP keeps health care cost low.

Apple Health for Kids This program provides health coverage for low income children. Washington has secured millions in new, flexible federal funding because of the state’s leadership in providing health care for children. physical exams, and dental check-ups.

Maternity Support Services Elimination of this program will impact 55,000 women with pregnancies at high risk for poor birth outcomes, resulting in expensive hospitalization such as low birth weight or prematurity. For example, low birth weight medical costs average $49,000 in the first year, compared to an infant with an appropriate weight: $4,551.

MSS has decreased low birth weight for Hispanic babies by 20% and African American babies by 50%.

Disability Lifeline This is the only source of medical care for individuals who are unable to work and don’t have access to employer based insurance coverage or the individual market.

Interpreter Services 70,000+ residents in Washington State will lose interpreter services. Inability to communicate with patients means increased medical errors or wrong or unnecessary treatment.

Prescription Drug Coverage Adult Medicaid pharmacy benefits for 277,000 clients.

30 | The Washington Nurse | Winter 2012

NURSING EDUCATION Washington’s health care needs grow, and health reform brings higher demand for access to quality to care. WSNA is working with coalition partners to increase nurse faculty recruitment and retention. About 23% of nurse educators are expected to retire by 2012. While WA State will need 60,000 RNs by 2020, current capacity would leave the state short 24,000 registered nurses.

VOLUNTEER MALPRACTICE INSURANCE A State program providing free malpractice insurance for volunteer health care providers, including RNs at free and low-income clinics is in jeopardy of being eliminated. Volunteer physicians, registered nurses, and other providers gave $82 million dollars of care to 67,500 patients in 2011 alone.

Legislative Affairs Hazardous Drugs in Workplace

ISSUE

Protection Against Exposure to Hazardous Drugs in the Workplace

H

ealth care workers are routinely exposed to hazardous drugs in the workplace such as antineoplastics to fight cancer.

It’s been known since the 1940s that antineoplastics affect health cells and tissue as well as cancerous cells. Nurses, when administering antineoplastics are at risk for bad health effects such as chromosomal aberrations during pregnancy. A 2005 report discovered that nurses who handle chemotherapy have a greater risk of offspring with learning disabilities. The daily handling of hazardous drugs without control measures like engineering and administrative controls along with personal protective equipment and safe work practices, increases a nurse’s vulnerability to early development of disease.

Substitute Senate Bill 5594 passed the legislature last year to require the Department of Labor and Industries pass regulations to ensure that health care facilities assess for the risk of exposure to hazardous drugs, put a plan in place, implement appropriate control measures, and provide training to personnel. Some facilities are raising concern about the cost of instituting these protections.

WSNA worked closing with the department to develop comprehensive proposed rules that prevent dangerous exposure and are consistent with other workplace practices such as universal precautions. Karen Bowman, WSNA Environmental Health Specialist and WSNA member Libby Zadra (an oncology nurse from Spokane) testified in support of the rules in public hearings. They spoke from their experience of hazardous drug exposure and the need for Labor and Industries to stay firm on its approach.

to 30 years later, we still have the same situation for many nurses in Washington State.

The current use of voluntary guidelines by hospitals and other facilities have not shown to prevent contamination of workplaces and exposure of nurses.

With all the voluntary guidelines in place, nurses and other health care providers are still exposed. Research shows that nurses who work with these toxic drugs are still at risk for anemia, thyroid dysfunction and benign and malignant tumor formation. We know that nurses who work with cytotoxic drugs have the highest rates of chromosomal aberrations compared to control groups, and research concludes that daily handling without control measures—like engineering and administrative controls along with personal protective equipment and safe work practices— increases a nurse’s vulnerability to early development of disease. Research is not lacking that demonstrates the need for better control measures, education and consistency with policy and procedure.

Guidelines for the safe handling of hazardous drugs have been in place since the late 1980s; however, confusion remains about the proper handling of the substances. Institutional policies vary and the use of personal protective equipment is inconsistent. We need clear and consistent regulation to prevent and reduce illness and injury associated with exposure to hazardous drugs and that is exactly what draft rule 296-62-500 WAC, Part R Hazardous Drugs, to implement SSB 5594 does.

Nurses are the largest health care provider workforce in Washington and in the United States. We can do better to protect this invaluable resource along with other health care facility employees. The Washington State Nurses Association supports the Department of Labor and Industry’s draft rule WAC 296-62-500, Part R Hazardous Drugs. It is consistent, health protective and just makes sense.

The following is an excerpt from Karen’s testimony.

My first experience as a nurse, like many nurses in Washington State, started in the hospital setting. It was routine for me to mix my own medications, including chemo drugs, on the little medication cart in the clean linen room; no gloves, no mask, no engineering controls. I didn’t realize I was being exposed on a daily basis to drugs associated with chronic disease and even cancers. That was back in the ‘80’s. Close

The Washington Nurse | Winter 2012 | 31

Legislative Affairs 2012 Platform

WSNA Legislative & Health Policy Platform

ACCESS TO QUALITY CARE

HUMAN RIGHTS

•

Support full access to safe, effective, patientcentered, timely, efficient, affordable, and equitable health care for all.

•

•

Support health promotion education, health literacy,and disease prevention as a major focus of the health care system.

Support the basic right of all people for equity under the law regardless of race, creed, color, gender, age, disability, lifestyle, religion, health status, nationality, or sexual orientation.

•

Promote a culturally competent health care system that recognizes and values differences among people.

•

Promote education of nurses, other healthcare providers and the general public about the problems of violence, bullying, sexual assault and harassment.

The Washington State Nurses Association provides leadership for the nursing profession and promotes quality health care for consumers through education, •

Address social determinants of health and support efforts to reduce health disparities.

•

Support implementation of the Washington State Strategic Plan for Nursing to address the nursing shortage.

Support comprehensive health care and wellness services in familiar, accessible and convenient community sites such as schools, workplaces and homes, as well as traditional health care settings.

•

Support implementation of the recommendations of the Institute of Medicine’s report on the Future of Nursing and the Master Plan for Nursing Education in Washington State.

Ensure access to nursing services that emphasize the role of registered nurses as qualified providers of health care in all practice settings.

•

Support nursing's leadership and unique role in the development and delivery of comprehensive and cost-effective quality care.

Enhance patient safety through a systems approach such as the prevention of medical errors and injuries.

•

Support and promote advanced practice registered nurses as primary care providers. .

advocacy, and influencing health care policy in the State of Washington.

NURSING PRACTICE & EDUCATION •

•

•

•

Support the principle of individual licensure as mandatory for the practice of registered nursing through completion of a RN education program approved by the Nursing Care Quality Assurance Commission.

•

Encourage specialty certification and advanced practice of nursing.

•

Support nursing education funding for:

FINANCING HEALTH & SOCIAL SERVICES •

•

1. Increased access to nursing programs within institutions of higher education 2. Nursing faculty salaries and faculty scholarships/loans

•

3. Specialty certification and advance practice preparation.

•

Ensure adequate and stable funding for state health plans, public health, and public health nursing services.

Support evidenced based cost containment incentives in the health care delivery system that do not compromise quality of care or increase health disparities and that: •

1. Grants and loans to encourage nursing recruitment and retention.

Apply to all providers, payors and vendors.

•

2. Increasing the diversity of the nursing workforce.

Are based on continued review of the appropriateness of health care services.

•

Serve to eliminate significant waste and inefficiency.

Support funding for:

3. Nursing research to maximize nursing’s contribution to health.

4. Data collection and analysis on the nursing workforce.

•

Support an equitable tax base and other methods which will provide adequate funding for needed social and health services and state agency oversight.

Protect the public by promoting the role and practice of registered nurses across all settings.

❱❱ Adopted by WSNA Board of Directors, December 2011

32 | The Washington Nurse | Winter 2012

•

Protect dedicated health funding and ensure it is used solely for health services.

ECONOMIC & GENERAL WELFARE •

Promote RN staffing standards to ensure quality care and safety for patients and health care providers.

•

Endorse and actively support the rights of all employees to participate in the collective bargaining process.

•

Support measures, including comparable worth and parity, which promote the economic welfare of all nurses.

•

Promote reimbursement policies that support the principle of equal payment for equal services provided.

•

Promote and seek enactment of legislation and regulation that protects the economic and employment rights of all nurses, including their right to advocate for patients.

•

Support measures that create a work environment where nurses are respected, valued, and included in leadership and decision making processes.

OCCUPATIONAL & ENVIRONMENTAL HEALTH •

Support research and education for the prevention and treatment of occupational and environmental health problems.

•

Support efforts to assure adequate prevention, preparedness, and response to natural, biological and chemical disasters, and acts of terrorism.

•

Support legislation and regulation that assures workplace safety, public safety, and promotes environmental health.

•

Support a precautionary approach towards occupational and environmental health.

Member News New Members

WHATCOM COUNTY Brar, Balwinder Duff, Linda Jappert, Sarah McCombs, Judith Nijjar, Sundeep Shahan, Allison Thom, Kristy Watson, Bronwynn

KING COUNTY Achacoso, Francis Adams, Sherry Aguasin, Maria Cristine Allakhverdyan, Jane Anderson, Carl Anderson, Janette Anderson, Michelle Arldt-McAlister, Julie Arndt, Teresa Bailey, Domenica Bailey, Kaitlyn Banal, Nicole Barkshire-Coonce, Kristine Battisti, Summer Beltran, Kolene Beringer, Lindsey Bjornstrom, Steffani Blay, Stacie Boudwin, Patricia Brady, Briana Brasseur, Andrea Brock, Aleah Brunner, Nicole Bryce, Sara Bulloch, Allyn Burton, Deborah Byers, Anissa Byrne, Laurie Candido, Jacqueline Candido, Melissa Carney, Susanne Carpenter, Meghan Carr, Natasha Castaneda, Leah Catlin, Kaitlin Catudio, Danielle Chapman, Jill Chavez, Xochitl Christly, Benjamin Chun, Lydia Clark, Carolyn Clark, Terry Cole, Rhonda Collins, Claire Costello, Dana Coulson, Linda Cruz, Deborah Dala, Elfira Daley, Alyssa Darling, Dawn Dasalla, Abbie Davenport, Katie Del Camp, Keely Des Jardens, Arielle Dickson, Elizabeth Dinnocenzo, Pamela

Drinnon, Allison Duerr, Jacquelin Dykstra, Sara Eastman, Heather Emami, Babak Erichsen, Katie Eshleman, Elizabeth Fargher, Kristen Fenstermacher, Sara Fernandez, Kelly Jean Fischer, Therese Franz, Amy Freeman, Lauren French, Allison Gaskill, Kaitlyn Gates, Bailey Gegantenio, Alice Geltman, Paulina Glennie, Sonia Goetz, Tamara Goodrich, Sarah Gordon, Katie Graham Murakami, Mary Graves, Angela Griffes, Ellen Grosenick, Martha Gumber, Rachael Guthrie, Heather Halpern, Brian Handulleh, Asha Hannafious, Tiara Hannon, Jennifer Hardesty, Kimi Hart, Amy Hebert, Christine Hendsbee, Katherine Hermer, Jacquelyn Hinkle, Aimee Hinshaw, Brynn Hoban, Kaitlin Horak, Susan Hossler, Robyn Howell, Kellee Hutchins, Eva Hylton, Casey Jackson, Alan Jackson, Karra Jaiteh, Ousman Jakubowski, Chris Jannusch, Tera Jeannot, Sophia Jensen, Stephanie Johnson, Christie Johnson, Whitney Jones, Amy Justus, Jacqueline Kalpakoff, Kathryn Kamitsuka, Lauren Kehner, Christine Khaleghi, Susan Killian, Kristen Kimball, Emilie King, Cristi Kirkpatrick, Christine Klauder, Jessie Kraft, Kelli Kundtz, Julie Kuritz, Patrick

Lackey, Jessica Lagunas, Megan Lake, Samantha Lames, Zeus Lao, Pauline Lau, Kathy Lee, Yeon Hoe Leisholmn, Heidi Linton, Sarah Little, Sharon Lord, McKenzie Lotshaw, Carla Luedecker, Carrie Lund, Emma Lynn, Aimee Macaraig, Christyne Martin, Melissa Marty, Kayla Mauro, Nicole McFerran, Rhonda McKinley, Kara Mistry, Hemlata Mittemiller, Maressa Mulflur, Kara Munns, Maren Murillo, Elena Murphy, Molly Murray, Carlie Namkoong, Lisa Navarra-Key, Jeannette Neher, Rachel Neshmonin, Anna Ngete, Linet Nguyen, Ngoc-Chau Nikodym, Jacqueline Ninan, Roopa Nonog, Jemma O'Connell, Marykate Ohnstad, Hannah Oleson, Megan Olson, Jessica Olson, Leslie Oman, Tara Opersteny, Esther Ott, Caren Otterbein, Heidi Owens, Katrina Perry, Jessica Peyton, Courtney Phoenix, Barbara Pickrell, Stephanie Piersol, Melissa Pomerleau, Amber Prentice, Katherine Rabung, Michael Rall, Jane Ralston, Caitlin Rassilyer, Brianna Ready, Melissa Reddoch, Jill Rheingans, Jordan Richard, Laura Riderburg, Andrea Rivera, Erika Roberts, Amy Robosa, Jeanelyn Rogers, Andria Rowell, Gail

Royston, Cathryn Ryu, Suzie Salandanan, Ryanne Saleh, Ahmad Sander, Julie Sanon, Marie-Anne Santos, Jerome Saunders, Genna Sayles, Rachel Schenkel, Priscilla Scheuer-Sturgeon, Elisabeth Schmidt, Sarah Schoolcraft, Kathryn Scott, Heather Scott, Jillian Scott, Marcy Seay, Renah Shalom, Edit Shannon, Gretchen Shannon, Sarah Sharpe, Melissa Shay, Kaelen Shea, Jessica Shingai, Noriko Shumpert, Christy Sikma, Suzanne Sikora, Lisa Silke, Barbara Simbulan, Melba Smith, Chelsea Smith, Margaret Smith, Sally Snyder, Ashley Snyder, Janae Songco, Paul Nicolai Soriano, Christiane Faith Speca, Emily St. Cyr, Nadine Stalmaster, Kristin Stemmler, Alicia Steppe, Cheryl Stillman, Margaret Sutton, Brett Swanson, Kaari Sweet, James Tachibana, Charleen Takisaki, Lauren Tangatailoa, Stacie Thomas, Heidi Thoreson, Ashley Tigno, Vincent Tilch-Bryant, Brandie Tilton, Alice Totten, Mary Tsai, Lauren Turner, Stephanie Tyan, Mei Tyrrell, Brooke Uberti, Katie Upton, Linda Vega-Talbot, Katie Viau, Noelle Violett, Amanda Wainer, Susan Waiss, Kelli Walker, Courtney Wallstrom, Laura

Member News Update

New Dues Rates in Effect

By Patrick McGraw

If you pay dues annually or by installment, then you may have already noticed the change. The new rates were made active for invoices mailed in December 2011 for the annual renewal period of January through December 2012 and for the installment renewal period of January through April 2012.

If you pay dues via payroll deduction, you should notice the change to your dues rate in your January 2012 paycheck.

Should you pay dues via electronic funds transfer (EFT), you will see a change to your dues rate in January 2012.

If you are not sure what your dues rate would be, please feel free to review the membership application for 2012. The membership application is available on the WSNA Web site.

Please feel free to contact the membership department for any questions related to dues amounts or dues payment by phone at 206.575.7979, by fax at 206.838.3099 or by email at membership@wsna.org.

MEMBERSHIP INFORMATION & EMPLOYMENT STATUS CHANGES It is the responsibility of each nurse to notify the Washington State Nurses Association of any change in work status which may include, but is not limited to: name, address, phone number, FTE increase or decrease, leave of absence, medical leave, maternity leave, leaving or joining a bargaining unit. This change must be done in writing either by using a Change of Information Card or sending an email to wsna@wsna.org The Cabinet on Economic and General Welfare (CE&GW) policy states: When a nurse is on an unpaid leave of absence, the dues are adjusted to the Reduced Membership Category during the unpaid Leave of Absence period. The accumulated dues payment is to begin within 90 days of return to work. The nurse will have up to twelve months to complete payment of these dues. It is the responsibility of the nurse to notify WSNA of this change in work status.

The Washington Nurse | Winter 2012 | 33

Member News New Members

Walter, Debra Wamugi, Julie-Ann Watt, Beverley Wedgwood, Josiah Wessner, Emily West, Samantha Wheeler, Lisa Whitbeck, Elizabeth White, John White, Kelsey Wilhelm, Britt Wolfe, Madison Wolter, William Wong, Sheena Wright, Emily Wright, Paul Wrightman, Sara Zanzi, Jennylle Zerby, Lisa

PIERCE COUNTY Aalmo, Michael Adams, Michelle Alston, Theresa Anderson, Jordan Arana, Nicole Assadi, Mary Bailey, Rishanne Baker, Lorraine Barcomb, Barry Bawden, Heather Bazzetta, Nicole Becker, Samantha Bell, Linda Berger, Heidi Berry, Karli Black, Desiree Blair, K.Taylor Bradley, Renee Brensinger, Stephanie Bruff, Michelle Bryan, Elena Cabilas, Kristianne Joy Camacho, Roseanna Cardinal, Jennifer Crespo, Angela Deichl, Leah Delaughter, Leila Delphy, Michele Devine, Thomas Diaz, Gerald Anthony Dinglasan, Gladys Doremus, Lisa Drakeford, Shonte' Dustin, Matthew Engberg, Elizabeth Engelhardt-Parales, Maria Jely Engelsvold, Jenna Erickson, Jodi Eschenfelder, Rachel Farber, Sharon Fernandez, Angela Flike, Kimberlee Fukuhara, Elizabeth Garbutt, Donna Gardenhire, Renee Gemma, Janice

Goetsch, Sarah Gomes, Terri Gonnerman, John Harden, Wendy Hardwick, Kelly Harris, Mindi Hausmann, Chantelle Heintz, Brittany Henderson, Susanne Hitchcock, Kelli Howard, Crystal Huh, Kevin Hyatt, Megan Ignaco, Jean John, Susan Johnson, Jesse Jones, Christy Jung, Stefanie Khalil, Denise Kimmerle, Maria Ladner, Kimberly Lamanna, Thomas Lamy, Joanna Lantz, Sabine Larson, Sarah Libago, Nelia Michaela Livernash, Eli Lowe, Angela Luzzo, James Ly, Chan Madson, Gabrielle Mang, Dickson Manginga, Socelinda Martin, Susan Matson, Charles Mayer, Lisa McCullough, Rachel McGrath, Marilisa McKee, Zaneta Miles, Scarlett Milholland-Fears, Michelle Minhas, Gurpreet Minnock, Jaime Moccia-Sattler, Judith Moore, Kristin Murphy, Natalie Murray, Alison Na, Sooh-Young Nera, Lope Nguyen, Thomas Norcott, Kalia Norwood, Kim Orallo, Shauna Lynn Patamia, Kimberly Paul, Dean Paulson, Diane Perez, Cristina Peterson, Cheryl Petty, Deborah Phillips, Carrie Pikla, Devin Pittman, Christal Randazzo, Cara Reaves, Dana Reiter, Laurel Richter, Alana Rivera, Amy Rogers, Sangai

34 | The Washington Nurse | Winter 2012

Rose, Linda Ross, Mary Ryan, Tara Sampson-Hall, Lanice Sanchez-Terry, Dana Sandoval, Victor Sasser, John Secrist, Jessica Skovold, Jaclyn Sliva, Kathleen Sokolovskiy, Olga Somera, Enrique Soriano, Katherine Spannagel, David Spurlin, Lindsay Steiner, Avril Stevens, Lisa Stone, Karen Stookey, Jodie Swan, Christina Thomas, Amina Thomas, Cynthia Thomas, Megan Thomas, Shamay Upton, Robert Van Dijen, Nicolaas Vanlierop, April Verhoeven, Lisa Walker, Kelley Weier, Kathryn Weinman, Jill Wellendorf, Megan Wells, Sharon Williams, Andrea Williamson, Lindsay Willoughby, Sarah Winslow, Ashley Yabroff, Eve Yakimets, Ruslana Zarella, Trudy

SPOKANE / ADAMS / LINCOLN / PEND OREILLE Abbey, Adrianne Adams, Anna-Marie Aiken, Nicole Anderson, Kali Balek, Molly Barton, Jessica Batson, Kendall Behan, Kimberly Bisson, Nicole Bolstad, Rebekah Boyer, Chad Bozlee, William Breuer, Pamela Bye, Trissica Carlsen, Brady Carper, Kari Chapman, Audrey Chapman, Heather Cornutt, Jennifer Deakins, Peter Di Carlo, Kristen Dorius, Nancy Eklund, Trisha Eldredge, Samantha Festner, Amanda

Ford, Debbie Foster-Fausett, Jennifer Frers, William Garner, Janine Garza, Marisol Godwin, Megan Grey, Joylene Guthrie, Andrea Harrigan, Laura Harris, Sara Hawkins, Laura Hayes, Heidi Hilzendeger, Kathryn Huppert, Heidi Johnson, Kelly Jordan, Alisa Keatts, Todd Kent, Melissa Kirkland, Vanessa Koberstine, Dianna Kopytjuk, Lira Lane, Kristin Lawrence, Harry Light, Carolyn Linderer-Hurley, Janice Lopez-Garcia, Emerald Louis, Robyn Lundt, Erin Lundy, Brittney Mackey, Elisabeth Marcotte, Rose Martell, Kelsey Martin, Stacy Martini, Cody Mason, Tanya Mellick, Yvonne Michael, Sarah Miller, Linda Minayev, Ruslana Moore, Karlyn Moore, Rachel Nelson, Eva Olmstead, Jessica Omari, Ednah Packwood, Katherine Page, Loni Park, Renee Payne, Bryan Peters, Meghan Pyper, Kimberly Read, Ashley Sands, Danielle Stoker, Megan Tara, Rachel Thomas, Jesin Thwing, Allison Tishenko, Konstantin Tran, Tra My Truitt, Allison Uhlman, Allyson Vanhoozer, Megan Wahler, Sarah Wieber, Kathleen

YAKIMA / NORTH YAKIMA Bickler, Shannon Gibson, Lana Ojeda, Melissa

CHELAN / DOUGLAS / GRANT Brown, Christiane Buhrman, Heidi Garcia, Patricia Garcia, Patricia Lachica, Ann Lagrange, Alison McKerlie, Brenda Moshe, Erica Ruud, Stacey Scott, Kathleen Smith, Sarah Ziker, Lynne

GRAYS HARBOR Ball, Barbara Freinwald-McMahon, Victoria Greeley, Tara Hopkins, Marianna Lane, Joli McEachern, Mario Mitchell, Robyn

WAHKIAKUM / COWLITZ Cramer, Jesse Dailey, Valerie Evans, Julie Nusbaum, Melissa Riutta, Kimberly Samhammer, John Wilkinson, Wendy

CLARK / SKAMANIA Allison, Tatetum Buchholz, Christy Chase, Jonathan Churchman, Adam Coffman, Ryan Coiteux, Bradley Cooley, Julie Decillo, Jackolyn Eckhart, Lisa Garner, S. Jane Hanna, Katherine Jenkinson, Teresa Langlois, Karla Marris, David Miller, Sarah Minnifield, Bernadette Nam, Jatuporn O'Reilly, Kady Quigley, Patrick Rivenburgh, Brandy Stoffel, Tamara Tagintsev, Nadya Thompson, Brenda Weisenborn, Janelle Yochim, Katharine Young, Kerri

CLALLAM / JEFFERSON Dworsky, Baila

WHITMAN COUNTY Leonard, Cynthia Reel, Sally

Robson, Ginger Smart, Katherine Weitz, Kerri

BENTON / FRANKLIN Blume, Gwendolyn Fleming, Ashley Garza, Amanda Gilbert, Mary Hoyt, Katie Mayberry, Jennifer McElroy, Laci Nguyen, Joanne Simpson, Jessica Sterry, Barbara Travis, Jackie Wichtendahl, Kathryn

SKAGIT / ISLAND / SAN JUAN Alvarado, Heather Anderson, Maxine Andestad, Lori Barger, Rebecca Bartlett, Diana Bentz, Bonnie Corr, John Edgley, Kirsten Hunt, Lorena Knight, Patricia Little, Taylor Maley, Bonnie McCormick, Angela Moulton, Kristin Nicholson, Paul Ringhouse, Alyssa Risenhoover, Janine Rosamonda, Jolene Sandretto, Laure Schmelz, Joyce Sheikh, Ajaz Shumate, Curtis Sklar, Amanda Strong, Nellie Tomaso, Lynnet Woods, Carly Worthing, Theresa

KITSAP COUNTY Scott, Cristen

KITTITAS COUNTY Graham, Andria Henson, Douglas Moon, Rachel

ALL OTHER COUNTIES Claborn, Michael Crane, Barbara Diaz-Zepeda, Claudia Gonzalez, Anabel Guzman, Kelly Mora, Sarah Neely, Tara O'Neal, Kasey Rosenow, Erika Sass, Leanne

Member News In Memoriam

Hilda Boerhave Roberts 1917- 2011 Hilda Boerhave Roberts died Thursday, September 29, 2011 at age 94. Born in Lynden, WA March 23, 1917 to John Peter Boerhave, who was manager of several departments in the Lynden Department Store, and Grace Pilon Boerhave, who was a nurse. Her parents were part owners of the Lynden Department Store for many years.

She graduated from Lynden High School in 1935.

Hilda graduated with a B.S. and a Master of Nursing from University of Washington and attended Columbia University taking coursework toward a doctorate.

Hilda worked as a nurse at King County Hospital in Seattle, WA; she was an instructor and supervisor at Good Samaritan Hospital in Portland, OR in the 1940's. She became an assistant professor and director of the School of Nursing at Washington State College in 1948. She was awarded a National Scholarship by Columbia University, NY and studied “Fellowship in Journalism” and “Nursing Education” in 1951. She became an associate professor in 1953.

She enjoyed traveling and toured Holland, England, Belgium, Norway, Sweden, France and Canada.

Hilda married William S. Roberts in 1956 at the Second Christian Reformed Church in Lynden. She and Bill celebrated their 55th wedding anniversary on August 21, 2011. They resided in Moscow, Idaho for most of their marriage.

While employed by WSU, she wrote and submitted grant proposals which earned the University $900,000 from 1968-1978.

She had many articles published in the Washington State Journal of Nursing and in the American Journal of Nursing.

During her career, Hilda belonged to the American Association of the University Professors, Sigma Theta Tau International Honor Society of Nursing, American Nurses Association, Kappa Delta Pi-education honorary, National League for Nursing, and Pi Lambda Theta-education honorary for women, Oregon State League for Nursing Education, Oregon State Nursing Association.

She was an officer in all the above organizations. She was appointed to the Washington State Board of Nurse Registration for five years by Governor Langlie and was chairman for three years. She also belonged to the American Nurse Association, Washington State Nurses Association, Whitman County Nurses Association, National League for Nursing, Washington State League for Nursing, University of Washington School of

Nursing Alumni Association and the Intercollegiate Center for Nursing Education Alumni Association.

Her many awards include: Certificate for meritorious service and wartime contribution as an instructor for US Cadet Nurse Corps, certificate of appreciation from Colonel Philip Day, Jr. for immeasurable support to the US Army Nurse Corps. Certificate of Appreciation from Governor Langlie for service on the Washington State Board of Professional Nursing, the Mary Roberts' Fellowship in Nursing to study at Columbia University, Certificate of appreciation from President Dwight Eisenhower in 1957 and President Richard Nixon in 1972 for service for the Nation and the National Advisory committee to the Selective Service System, Meritorious Service Award from the Selective Service System in recognition for longtime service.

She invented a syringe medical tray, an adjustable tray for holding syringes and medicines in the 1940's. She took her design to the Washington State Institute of Technology at WSC and it was manufactured by them in 1948 and was used in hospital wards.

Hilda retired from Washington State University in 1982 after 37 years. As the Director of the School of Nursing, a scholarship was established in her name, the “Hilda Boerhave Roberts Scholarship” by the WSU Nursing Department for campus nursing students. In 1989, one floor of the Regents Hill Resident Hall was named the “HILDA B. ROBERTS HOUSE.” Hilda was awarded the WSU School of Nursing's Distinguished Alumna Award in 1989.

Her love of nursing was evident all her years as she mentored so many women in their nursing careers while they were in college and after they graduated. She kept her nursing license valid even after her retirement in 1982.

Hilda was preceded in death by her parents; brother John W. Boerhave and wife Dorothy (Kroontje); sister Margaret (Boerhave) and husband Richard McCoy; and nephew John E. Boerhave. She is survived by her loving husband, William S. Roberts of Lynden; nephew Bill McCoy, nieces Joyce (Boerhave) and husband Lloyd Tobiassen, Nancy McCoy, Marilyn McCoy and husband Patrick Jones, Patricia (McCoy) and husband Oral Keen and several great nieces and nephews. ❱❱ Memorials may be sent to: Hilda Boerhave Roberts Scholarship Fund, Washington State University, College of Nursing, P.O. Box 1495, Spokane, WA 99210.

The Washington Nurse | Winter 2012 | 35

Member News March of Dimes Awards

March of Dimes Nurse of the Year Awards On December 8, 2011 the March of Dimes annual Nurse of the Year awards were presented during a breakfast program at the Meydenbauer Center in Bellevue, WA. Ninety-five nurses were nominated by their peers, in 14 categories for their contributions to the nursing profession and to patient care.

WSNA CONGRATULATES THE RECIPIENTS OF THE 2011 NURSE OF THE YEAR AWARDS Nelson Monastrial, RN Harrison Medical Center Patient/Clinical Care A Nurse who demonstrates excellence in delivering care directly to the patient in any clinical setting.

Gayle Lanier, MN, RN Snohomish Health District Leadership A nurse who has demonstrated exceptional leadership in nursing or patient care services in any setting

Sarah Baumann McMorris, BSN, RN Overlake Hospital Medical Center Innovation / Creativity A nurse who has made innovative / creative contributions that have improved patient care.

Brenda Newman, BS, RN Swedish Edmonds Education A nurse who has made significant contributions in education, professional development, and / or long-term learning of nursing professionals.

Dawn Corl, MN, RN, CDE Harborview Medical Center Research / Advancing the Profession A nurse who has made contributions that have advanced research or advanced the nursing profession.

36 | The Washington Nurse | Winter 2012

Molly Ruddy, RN* Seattle Children's Hospital Mentoring A nurse who provides positive, professional influence, guidance, and support of other nurses in any setting.

In her role as unit based educator, Molly mentors nurses in the pediatric intensive care unit on a daily basis. Molly designed and developed a program that brings new graduates into the PICU after completion of a six month residency. It is because of Molly’s commitment to each of these new nurses that the program has been so successful.

Molly is supportive both professionally and personally and is often cited by new graduates as the individual who helped them most in their residency program.

Cathi Woolley, RN Snoqualmie Valley School District School Nurse RNs who provide direct care to children in grades K-12 and has made a lasting contribution to the health of students.

Robin Evans Agnew, MN, RN, PhC University of Washington New Generation A nursing student who has demonstrated outstanding professionalism and mastered the coursework necessary for a successful nursing career.

Christine DeBois, BSN, RN Swedish Medical Center Perinatal / Pediatric A nurse whose influence and service in the care of pregnant mothers and babies exemplifies the mission of the March of Dimes to improve the health of babies.

Sarah Reid, RN* PeaceHealth St. John Medical Center Advocacy for Patients A nurse who goes beyond the call of duty to advocate for patients.

Sara is a staff nurse and Sexual Assault Nurse Examiner in the Emergency Department at St. John Medical Center.

Sara is often called in on short notice to provide care for victims of sexual assault. In addition to caring for adult victims of sexual assault, Sara is also the sexual assault nurse examiner for pediatric patients at the Child and Justice Advocacy Center. Sara is considered by the sexual assault advocates and prosecuting attorneys she works with to be a caring and compassionate expert for vulnerable patients. Sara is a tireless advocate for her patients and continues to work to improve the Sexual Assault Nurse Examiner program.

Eileen Reichert, ARNP* Seattle Children's Hospital Community Service A nurse who has made significant professional or voluntary contributions in community-based settings, such as public schools or community outreach efforts.

Eileen is the Program Coordinator for the Pediatric Advanced Life Support Training Center which provides training to health professionals across the state. She ensures that each class will give the attendees the knowledge and skills they need to save a child’s life in an emergency. Her courses are given the highest praise by colleagues and she is well known for her leadership and outstanding quality assurance.

She also initiated a Pediatric Basic Life Support course for families of children with special needs. Eileen also works to produce numerous outreach education events for regional and international professionals.

Member News March of Dimes Awards

Christine Anderson, RN*

Julia Weinberg, RN*

Franciscan Health Systems – St. Joseph Medical Center – Tacoma

Skagit Valley Hospital

Rising Star A nurse who, within the first 18 months of practice, exemplifies outstanding caring, leadership, and professionalism.

Since obtaining her Registered Nurse license in 2009, Christine has demonstrated ease in her skills and shows great compassion for her work. She is a leader, patient advocate and great team player. In the past year, Christine has served on process improvement teams where she has proven herself an ambassador for change. She willingly pilots new ideas and works to ensure they are successful. In her relatively short time as a nurse, Christine has a long list of accomplishments to her name.

deserve. She worked with hospital management and was instrumental when her hospital made several significant changes including moving to a stick free needleless system. She has also acted as the historian for many labor contracts and has initiated safe standards of care.

As the current president of the Washington State Nurses Association, she advocates for legislative priorities that benefit nurses, nursing and health in this state and beyond.

Distinguished Nurse of the Year A nurse whose contributions and accomplishments have had an extraordinary influence within the nursing profession in Western Washington.

Julia is a staff nurse whose contributions have not only advanced nursing practice in her hospital, but statewide.

She has a great devotion and love for the nursing profession and is tireless in her efforts to be involved with staff members in all departments and on every floor of the hospital.

Antonia Alejo, RN Virginia Mason Medical Center Legend of Nursing A retired nurse whose lifetime career has advanced the field of nursing for all generations to come.

She has encouraged many nurses to participate in committees, focus groups and department activities and decisions, always with the purpose of upholding high nursing standards and to provide the safe, quality care our patients

* Is a member of WSNA

WSNA WOULD LIKE TO RECOGNIZE 24 WSNA MEMBERS THAT WERE NOMINATED BY THEIR PEERS FOR THE 2011 MARCH OF DIMES NURSE OF THE YEAR AWARDS Denise Asdal, RN-BC PeaceHealth-St Joseph Medical Center – Bellingham Kathy Eaton, BSN, RN Seattle Children's Hospital Michelle Meerdink, RN Franciscan Health Systems – St. Joseph Medical Center – Tacoma

Janna Brick-Uffelman, BSN, RNC-OB University of Washington Medical Center Jennifer Gray, RN Franciscan Health Systems – St. Joseph Medical Center – Tacoma LeeOni Pinkley, RN Ocean Beach Hospital

Yasmine Ayzam, BSN, RN-BC Franciscan Health Systems – St. Joseph Medical Center – Tacoma

Molly Brown, MBA, BSN, RN Seattle Children's Hospital

Kevin Garcia, RN Virginia Mason Medical Center

Courtney Hurst, BSN, RN, CCRN Seattle Children's Hospital

Maria Pastores, RN Franciscan Health Systems – St. Clare

Jennifer Reilly, RN, CPN Seattle Children's Hospital Sally Budack, RN-BC Franciscan Health Systems – St. Joseph Medical Center – Tacoma

Raquel Jones, BSN, RN Franciscan Health Systems – St. Clare Randee Robinson, BSN, RN Franciscan Health Systems – St. Joseph Medical Center – Tacoma Arceli Caldejon, RN Franciscan Health Systems – St. Joseph Medical Center – Tacoma Matthew Kennedy, RN PeaceHealth-St Joseph Medical Center – Bellingham

Barbara Lafayette, RN Seattle Children's Hospital Lauren Ryerson, RN Seattle Children's Hospital Debbie DiMaio, RN Overlake Hospital Medical Center Amanda Mackey, BS, RN Franciscan Health Systems – St. Clare Amy Soule, RN Skagit Valley Hospital

Jason Russo, RN Seattle Children's Hospital Evan Delay, MSN, BA, RN University of Washington Medical Center

The Washington Nurse | Winter 2012 | 37

Education Calendar

F E B R U A RY 2 0 12

M A R C H 2 0 12

A P R I L 2 0 12

Midwifery Update 2012—13th Annual Pacific Northwest Conference University of Washington Continuing Nursing Education; February 1; Fee: $245/225; Contact Hours: 7.3 (4 pharm hrs). Contact: www.uwcne.org/secure/display3.asp?SKU=12105-C

STD Update for Clinicians Yakima, WA, March 1, 2012,. Contact the Seattle STD/ HIV Prevention Training Center via seaptc@uw.edu and Register Online at www.seattlestdhivptc.org

Wound Management Fundamentals Course—Spring 2012 A Certificate Program for Healthcare Professionals; April 2—May 19, 2012; Fee: $595; Contact Hours: 30, Contact: www.uwcne.org/secure/display3.asp?SKU=12180-SP

Pharmacotherapeutics for ARNPs Pacific Lutheran University/Tacoma; February 3, 2012; Fee: $169.00; Contact Hours: 7.5; Register at www.plu.edu/~ccnl/ or call 253.535.7683

Spanish for Health Care Providers Pacific Lutheran University/Tacoma; March 2 & 16, 2012; Fee: $239.00; Contact Hours: 12.5; Register at www.plu.edu/~ccnl/ or call 253.535.7683

Preceptor Training for Nurses Virginia Mason Medical Center /Seattle; February 6, 2012; Fee: $ 175; Contact Hours: 7.5; Register at CNE@vmmc.org or call 206.583.6567

Annual Neuroscience Nursing Symposium— Expertise, Knowledge and Innovation University of Washington Continuing Nursing Education; March 2; Fee: $245/225; Contact Hours: 7.3. Contact: www.uwcne.org/secure/display3.asp?SKU=12108-C

2012 Medical-Surgical Potpourri – Two Day Virginia Mason Medical Center /Seattle; February 7 & 8, 2012; Fee: $ 175; Contact Hours: 7.8 / 7.6; Register at CNE@vmmc.org or call 206.583.6567

2012 GI Potpourri: Spring Update Virginia Mason Medical Center; Saturday, March 3, 2012; Fee: $175 CH: 7.2; Register at CNE@vmmc.org or call 206.583.6567

Wound Management (Winter/Spring Course) University of Washington School of Nursing; February 8 – April 12, 2012; Fee: $3,795; Contact Hours: 130.0, Contact: www.uwcne.org/secure/display3.asp?SKU=12140-C

Touching Hearts: The Art & Science of Labor Support for Nurses Patti Ramos Family Education Center; March 10, 2012; Fee: $125; Contact Hours: 6.0; Contact: wyzwomn2011@gmail.com

Health Care Resources Management Pacific Lutheran University/Tacoma; February 10 – May 25, 2012; Fee: $679.00; Contact Hours: 37.5; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Cardiovascular Care Update 2012 University of Washington School of Nursing; February 16-17, 2012; Fee: $345; Contact Hours: 14.2, Contact: www.uwcne.org/secure/display3.asp?SKU=12140-C Update on The Management of STDs and HIV Prevention, with Optional Clinical Practicum Seattle, WA. February 16-17, 2012,CE Available, Contact the Seattle STD/ HIV Prevention Training Center via seaptc@uw.edu and Register Online at www.seattlestdhivptc.org Tools and Tips to Improve Your Safety Training Course University of Washington Northwest Center for Occupational Health and Safety Continuing Education; Feb. 29, 2012, Seattle, WA; Contact: http://osha.washington.edu The Changing World of Diabetes—Update 2012 February 29, 2012; Fee: $245/$225; Contact Hours: 7.3 (2.3 pharm hours), Contact: http://uwcne.net/secure/display3.asp?SKU=12111-C

Why Wait, Simulate! Simulation for Successful Educational Outcomes University of Washington Shoreline Conference Center; March 20, 2012, Contact Hours: 7.1 C Exploring Reiki in Nursing Practice at 8 AM-10:15 AM and Reiki I in Nursing Practice at 10:45-4:15 PM Soar With the Eagles; March 24, 2012, 28203 22nd Ave. S., Federal Way, WA; Contact Hours: 2.0 and 4.0; Fee: $35 and $85; Information and registration: http://reikitrainingfornurses.com Essential STD Exam Skills Seattle, WA, March 26-27, 2012, CE Available, Contact the Seattle STD/ HIV Prevention Training Center via seaptc@uw.edu and Register Online at www.seattlestdhivptc.org Diabetes 101: What Every Nurse Should Know Pacific Lutheran University/Tacoma; March 30, 2012; Fee: $69.00; Contact Hours: 3.8; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Wound Care: Management of Peripheral Vascular Disease and Pressure Ulcers Pacific Lutheran University/Tacoma; March 30, 2012; Fee: $69.00; Contact Hours: 4.0; Register at www.plu.edu/~ccnl/ or call 253.535.7683

Certification Review Course for the National Board for Certification of School Nurses (NBCSN) Exam Pacific Lutheran University/Tacoma; April 12, 26, May 10 & 24, 2012 (online via PLU Sakai); Fee: $219.00; Contact Hours: 12.5; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Falls and the Older Adult: A Holistic Approach to Identifying and Managing Risks and Consequences Pacific Lutheran University/Tacoma; April 12, 2012; Fee: $69.00; Contact Hours: 3.8; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Wound and Skin Care Pacific Lutheran University/ Tacoma; April 12, 2012; Fee: $69.00; Contact Hours: 4.0; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Bullying & Harassment: A Sepsis in HealthCare North Dakota Nurses Association; April 13, 2012; Fee: $127.50; Contact Hours: 5.75; Register at judy.beck@trinityhealth.org Dementia Care: The Tools You Need to Make a Difference Pacific Lutheran University/Tacoma; April 13, 2012; Fee: $69.00; Contact Hours: 3.8; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Foot Care for Older Adults, Update 2012 University of Washington Continuing Nursing Education, April 13, 2012; Fee: $245/225; Contact Hours: 7. Contact: www.uwcne.org/secure/display3.asp?SKU=12116-C Basic Preparation Course for Parish Nurses Pacific Lutheran University/Tacoma; April 16, 17, 18 & May 14 & 15, 2012; Fee: $489.00; Contact Hours: 25; Register at www.plu.edu/~ccnl/ or call 253.535.7683 Monitoring for and Managing Delirium: Mandate for Patient Safety Pacific Lutheran University/ Tacoma; April 21, 2012; Fee: $69.00; Contact Hours: 3.8; Register at www.plu.edu/~ccnl/ or call 253.535.7683

C O N TA C T S

A

Carol M. Stock & Associates Carol M. Stock, JD, MN, RN PO Box 31114 Seattle, WA 98103 (206) 789 – 0909 cstock@carolstock.com www.carolstock.com/videos/ communication.html

B

Medical Spanish.com Ken Ryan PO Box 190913 Anchorage, AK 99519 keninalaska@gmail.com www.medicalspanish.com

38 | The Washington Nurse | Winter 2012

C

University of Washington School of Nursing Continuing Nursing Education Box 359440 Seattle, WA 98195 206.543.1047 CNE@UW.Edu www.uwcne.org

D

Intercollegiate College of Nursing Washington State University College of Nursing Professional Development 2917 W. Fort George Wright Dr. Spokane, WA 99224 509.324.7321 or 800.281.2589 www.icne.wsu.edu

Education CEARP

I N D E P E N D E NT S E L F STU D Y C O U R S E S AIDS: Essential Information for the Health Care Professional Contact Hours: 7.0; Fees: $55 D

Legal Issues & Trends in Telephone Triage Contact Hours. 1.2 A

Tubes & Drains Techniques, Tips & Troubleshooting Contact Hours: 2.0 C

Breaking the Cycle of Depression Contact Hours: 14.0 C

Legal Issues in Nursing Contact Hours: 4.0; Fees: $120 D

University of Washington Continuing Nursing Education Offers over 30 self-study courses

Central Venous Catheter Infections: The Link Between Practice and Infection Rates Contact Hours: 1.0; Fee: $10 C Clinical Pharmacology Series Contact Hours: 7 – 8.0; Fee: $195 / 175* C Domestic Violence Contact Hours: 2.0; Fee: $20 C Ethics as a Compass: A Model for Dealing with Complex Issues in Patient Care Contact Hours: 7.4; Fees: $195 C Ethics Related to Nursing Practice Contact Hours: 9; Fees: $200 D Everyday Encounters: Communication Skills for Successful Triage Contact Hours: 1.4 A Geriatric Health Promotion Lecture Series Contact Hours: 63 Fee: $395; 1.5 Fee: $30 C Hepatitis Case Studies Contact Hours: .5 C Hepatitis Web Studies Contact Hours: .5 C Health Assessment and Documentation Contact Hours: 20: Fees: $150 D High Cholesterol Pt. 1: Western Medicine Contact Hours: 7; Fee: $50; Contact: www.healthcmi.com High Cholesterol Pt. 2: Chinese Medicine Theory Contact Hours: 4; Fee: $50; Contact: www.healthcmi.com High Cholesterol Pt. 3: Chinese Medicine Dietetics Fee: $50; Contact Hours: 12; Contact: www.healthcmi.com HIV / AIDS Contact Hours: 7.0; Fee: $95 / $85 C IMPACT: Web-Based Training in Evidence Based Depression Care Management Contact Hours: 12.4 C

Legal Risks of Remote Triage Contact Hours. 1.0 A Managing Type 2 Diabetes Contact Hours: 1.5; Contact: www.nphealthcarefoundation.org Management of Persistent Pain Contact Hours: 1.8; Fee: No Fee; Contact: www.nphealthcarefoundation.org Medical Spanish for Hospital Nurses Contact Hours: 25 B Medical Spanish for Office Nurses Contact Hours: 25 B Medical Spanish for NPs, Physicians and PAs – Course A Contact Hours: 25 B Medical Spanish for NPs, Physicians and PAs - Course B Contact Hours: 25 B Medical / Surgical Review and Update – 2012 “Enhance Medical Surgical Nursing Practice” Contact Hours: 50 C

C Wound Academy – Course 1 (Wound Assessment & Preparation for Healing) Fee: $40; Contact Hours: 4.3 C Wound Academy – Course 2 (Lower Extremities and Pressure for Ulcers) Fee: $60; Contact Hours: 6.8 C Wound Academy – Course 3 (Dressing Selection & Infection) Tuition; Fee: $30; Contact Hours: 2.5 C Wound Assessment and Documentation Fee: $60; Contact Hours: 2.0 C Wound & Ostomy Fee: $60; Contact Hours: 2.0 C

Continuing Education (CEARP) Orientation March 2, 2012 9:00 a.m. – noon Are you interested in having your CNE contact hours approved by WSNA? Are you new to the WSNA CEARP (Continuing Education Approval and Recognition Program) process? Attend this free CEARP orientation program and gain increased skills in completing WSNA CEARP “CNE activity & provider unit application” forms.

WSNA Office 575 Andover Park West, Suite 101 Seattle WA 98188 Snacks, coffee and tea will be provided.

RSVP by calling Irene at 206.575.7979, ext 0, and provide your name, facility / agency, email address, and telephone number. We will send additional details about the event shortly before March 2nd.

ADVERTISEM ENT

New Telehealth Technology: Legal Risks & Call Center Benefits Contact Hours. 1.2 A Nurse Grand Rounds

C

OTC Advisor: Advancing Patient Self-Care Contact Hours: 17.0; Contact: www.nphealthcarefoundation.org Prescribe, Deny or Refer?

Honing Your Skills in Prescribing Scheduled Drugs Contact Hours: 10.4; Fee: $155 / 140* C RN Refresher Course Fees Theory: $500; Health Assessment and Skills Review: $500; Clinical Placement for Precept Clinical Experience: $400 D Telephone Triage Trivia Contact Hours. 1.0 A The Pain Management Dilemma Contact Hours: 1.5; Contact: www.nphealthcarefoundation.org

NursiNg Program rN to BsN degree master of Nursing Course content relevant to your clinical practice.

• Nursing classes 1 day/week • BSN in Bothell, Everett and Mt Vernon (minimum 4-5 quarters) • MN Friday classes (7 or 11 quarters)

uWBNursing@uwb.edu 425.352.5000 | www.uwb.edu Get Connected

The Washington Nurse | Winter 2012 | 39

Need Help Organizing Your Continuing Competency Records?

This folder can be personalized to help you file information verifying compliance with the new NCQAC licensure renewal requirements.

Design your own file folder. Insert tab dividers (included) pertinent to your practice / education documents verifying compliance.

Billing Address ___________________________________

Shipping Address ___________________________________

Name ________________________________________________________________ Address ________________________________________________________________

Name ________________________________________________________________ Address ________________________________________________________________

________________________________________________________________ City ________________________________________________________________

________________________________________________________________ City ________________________________________________________________

State________________ Zip_____________________________________

State________________ Zip_____________________________________

_______________________________________________________________ Phone

_______________________________________________________________ Phone

__________ Folders x $10.00 per folder

= ________ Total

If Paying by Credit Card: ______________________________________________________________ Cardholder Name ________________________________________________________________ Cardholder Signature ________________________________________________________________ Card Number ________________________________________________________________ Card Expiration

Place your order by mail, phone or fax: Washington State Nurses Association • 575 Andover Park West, Suite 101 • Seattle, WA 98188 206.575.7979 phone • 206.575.1908 fax • wsna@wsna.org • www.wsna.org

Education News & Upcoming Events

Save the Date!

The Future of Healthcare March 29, 2012, 9 am – 5 pm Carlson Theater Bellevue College 3000 Landerholm Circle SE Bellevue WA, 98007

Robert Tennant, MA MGMG Senior Policy Advisor Robert focuses on federal legislative and regulatory health information technology issues, including the Health Insurance Portability and Accountability Act (HIPAA), electronic health records, electronic prescribing and ICD-10.

Doug Keeley

WSNA Introduces Speakers Bureau Our speakers address a wide range of topics of critical importance to nurses throughout our state. The speakers listed will provide at least a 1.0 contact hour lecture on behalf of WSNA. These lectures are provided at no cost to WSNA Districts, Local Units, or Schools of Nursing. Other organizations pay $250 in addition to the speaker’s travel and lodging expenses. Payment should be made to the Washington State Nursing Foundation.

Speaker’s fees will support scholarships and mini-grants provided by the Washington State Nurses Foundation.

• Health Reform and Implications for Nursing

• Political Advocacy: A necessary role for nurses

• Continuing Competency (overview of new rules)

• Preventing Violence in the Workplace • Safe Staffing Law and How to be an Effective Committee Member

• Compassion Fatigue • Creating a Culture of Safety

CEO & Chief Storyteller The Mark of a Leader

• Running on Empty: Fatigue and its Implications for Patient and Nurse Safety

The Mark of a Leader was created by a team of global communications experts and storytellers committed to using the latest and most powerful multimedia tools to help organizations create better leaders. CEO and Chief Storyteller, Doug Keeley, is one of North America's leading communicators, and a selfprofessed “leadership junkie.”

• Leadership, Political Advocacy, and Your Professional Association

• Social Media: Is your job in peril over your next facebook posting?

• Stress Management in a Hurry

❱❱ For a full list of topics, speakers and contact information: www.wsna.org/speakers The Washington State Nurses Association Continuing Education Provider Program (OH-231, 9-1-2012) is an approved provider of continuing nursing education by the Ohio Nurses Association (OBN-001-91), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

“What Happens When Something Goes Wrong?”

Attend a free class on Creating a Culture of Safety. and recieve 3 continuing education contact hours!

Topics • What constitutes a Patient Safety Culture?

• What do you do when something bad happens?

• Do you know about nurses being a “second victim”?

• What happens if you are reported to the Nursing Commission for an error?

• Should you carry liability insurance?

Registration Call Irene at 206.575.7979 x.0 to register.

LO C AT I O N S & DAT E S

Tacoma

Sally Watkins, PhD, RN

February 11, 2012, 9 am ­– 1 pm

Assistant Executive Director Nursing Practice, Education, and Research, WSNA

Jackson Hall 314 Martin Luther King Jr. Way Tacoma, WA 98405

Paula Meyer, MSN, RN Executive Director, Nursing Care Quality Assurance Commission

Vancouver March 14, 2012, 5:00 pm – 8:30 pm Dinner provided Heathman Lodge 7801 NE Greenwood Dr Vancouver, WA 98662

Pat McCotter, JD, RN Senior Healthcare Risk Management Consultant, Physicians Insurance, Seattle

Sarah Shannon, PhD, RN Skagit Valley April 25, 2012, 5:00 pm – 8:30 pm Dinner provided

The Washington State Nurses Association Continuing Education Provider Program (OH-231, 9-1-2012) is an approved provider of continuing nursing education by the Ohio Nurses Association (OBN-001-91), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

SPEAKERS

Assoc. Professor, Clinical Ethicist, University of Washington Medical Center, Seattle

Skagit Valley Casino & Resort 5984 N. Dark Lane Bow, WA 98232

The Washington Nurse | Winter 2012 | 41

Hall of Fame

Washington State Nurses Association

Honoring

Helen Behan, MN, RN * Helen Kuebel, MSN, RN Frankie T. Manning, MSN, RN * Maureen B. Niland, PhD, MS, BSN, RN Gretchen Schodde, MN, ARNP, FNP-BC * Beverly Smith

March 27, 2012

5:30 p.m. — 8:30 p.m.

Salty's on Alki 1936 Harbor Avenue SW, Seattle, WA 98126 $40 per guest includes dinner

Washington State Nurses Association 575 Andover Park West, Suite 101, Seattle WA 98188

www.wsna.org/hall-of-fame

 Detach and return by mail to WSNA, 575 Andover Park West, Suite 101, Seattle WA 98188 or fax to 206.575.1908 Registration Form

2012 WSNA Hall of Fame Awards Guest Name / Address

____________________ guests x $40 = $______________________ payable by:

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

 MasterCard  VISA  Check (written to ‘WSNA’) _________________________________________________________________________ Cardholder Name

___________________________________________________ ____________________ Card Number

Exp Date

_________________________________________________________________________ Billing Address

_________________________________________________________________________ City

State Zip

_________________________________________________________________________ Phone Number

Washington State Nurses Association 575 Andover Park West, Suite 101 Seattle, WA 98188

NONPROFIT ORG. U.S. POSTAGE PAID Seattle, Washington Permit No. 1282

Because brilliance takes a spark.

Energize your health care career with a certificate or degree.

UW Professional & Continuing Education partners with the UW Schools of Medicine, Nursing, Social Work and Public Health to offer you online, evening or weekend programs in nursing, health care administration, mental health, health informatics, gerontology, research, public health and more. Visit us online to explore your options.

www.keeplearning.uw.edu